CLAIMS ADJUSTER II WKRS COMP

MARTA (Metropolitan Atlanta Rapid Transit Authority); Atlanta (GA); On-site; USD 44,000 - 66,000; Full time

Job summary

MARTA is seeking a Claims Analyst to process, investigate, negotiate, and resolve complex Workers’ Compensation claims. The role involves determining diagnosis, treatment, prognosis, and compensability of workplace injuries with minimal supervision.

Under general direction, the position performs major assignments that affect business operations and may guide lower-level adjusters. The role requires strong analytical, negotiation and documentation skills.

Qualifications

• Bachelor's degree plus two years experience in the administration, negotiation, adjudication, and resolution of Workers’ Compensation claims.
• Experience with Georgia self-insurer preferred.
• In lieu of a degree, directly related experience may be substituted year-for-year.

Responsibilities

• Obtains information necessary to determine the Authority's legal liability in the most complex bodily injury, personal injury or property damage cases through observations of physical sites, interviews with witnesses, and reviews of medical and/or police reports.
• Evaluates findings and prepares written reports documenting conclusions and recommending actions based on an analysis of the evidence.
• Determines liability and extent of damages (property and/or personal), recommends monetary settlement, if applicable, and negotiates with claimant.
• Ensures that scheduled payments are made on a timely basis and in compliance with all applicable rules, regulations, and/or conditions governing each specific claim; ensures that all claim records and files are properly maintained.
• Provides information and assistance to the General Counsel in the resolution of claims under litigation.
• Provides guidance, coordination, training, and direction to lower level claims adjusters in the resolution of claims.
• Carries out major assignments in conducting the operations of the business.
• Performs work that affects business operations to a substantial degree.
• Maintains diary review of claim files.
• Performs other related duties as assigned.

Skills

Negotiation

Investigation

Documentation

Analytical thinking

Communication

Education

Bachelor's degree in Risk Management, Insurance, Business Administration or related field

Job description

Job Description

POSITION POSTED UNTIL A VIABLE POOL OF CANDIDATES HAS BEEN ESTABLISHED

THIS POSTING IS TO FILL THE CURRENT VACANCY AND TO ESTABLISH AN ELIGIBILITY LIST TO FILL ANY FUTURE VACANCIES THAT MAY OCCUR IN THE NEXT 6 MONTHS

EDUCATION And/or EXPERIENCE

Bachelor's degree in Risk Management, Insurance, Business Administration or related field, plus two years experience in the administration, negotiation, adjudication, and resolution of Workers’ Compensation claims (preferably with a Georgia self-insurer). In lieu of a degree, directly related experience as described above may be substituted on a year-for-year basis.

INTERVIEW SELECTION PROCESS:

The selection process may include one or more components to demonstrate applicants’ knowledge, skills and abilities in job related areas. These may include exercises such as practical demonstrations, written communications, oral interviews and/or competency assessments

Summary

Under minimum supervision, serves the Authority by processing, investigating, negotiating, and resolving the more detailed claims for benefit entitlement under Workers’ Compensation. Under general direction, determines the diagnosis, treatment, prognosis, and compensability of claims for medical and indemnity benefit entitlement incidental to injuries which occur in the workplace. Carries out major assignments in conducting the operations of the business. Performs work that affects business operations to a substantial degree.

Essential Duties And Responsibilities

• Obtains information necessary to determine the Authority's legal liability in the most complex bodily injury, personal injury or property damage cases through observations of physical sites, interviews with witnesses, and reviews of medical and/or police reports.
• Evaluates findings and prepares written reports documenting conclusions and recommending actions based on an analysis of the evidence.
• Determines liability and extent of damages (property and/or personal), recommends monetary settlement, if applicable, and negotiates with claimant.
• Ensures that scheduled payments are made on a timely basis and in compliance with all applicable rules, regulations, and/or conditions governing each specific claim; ensures that all claim records and files are properly maintained.
• Provides information and assistance to the General Counsel in the resolution of claims under litigation.
• Provides guidance, coordination, training, and direction to lower level claims adjusters in the resolution of claims.
• Carries out major assignments in conducting the operations of the business.
• Performs work that affects business operations to a substantial degree.
• Maintains diary review of claim files.
• Performs other related duties as assigned.

CERTIFICATES, LICENSES, REGISTRATIONS

None required.

Classification: Non-Represented

Number of Openings: 1

Salary Grade: 14

Salary Range: $43,828-$65,741

Americans With Disabilities Act

If you are a qualified individual with a disability, you have a right to request that MARTA make reasonable accommodations in order to help you accomplish your work, which must still be performed in all its essential functions.

MARTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state or local protected class.