Entry-Level Workers' Comp Claims Adjuster

Blue Cross Blue Shield of Michigan; Wisconsin; Hybrid; USD 48,000 - 81,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking an entry level professional claims handler focused on workers’ compensation. The role handles medical and indemnity benefits, determining compensability and reserves as needed.

Responsibilities include verification of coverage, investigation of claims, and facilitating return to work while negotiating settlements within authority and ensuring compliance with state rules.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• One year of relevant claims experience or completion of a claims trainee program.
• Bilingual skills preferred.

Responsibilities

• Verifies workers’ compensation coverage of employers and injured employees.
• Determines compensability under workers’ compensation by investigating the claim.
• Determines causal relationship between injury and incident for benefits.
• Facilitates return to work for the injured employee.
• Establishes reserves within authority based on anticipated financial exposure.

Skills

Computer literacy

Medical terminology

Legal terminology

Workers' comp laws

Communication skills

Customer service

Negotiation

Multitasking

Attention to detail

Team player

Education

Bachelor’s degree

Job description

Blue Cross Blue Shield of Michigan is seeking an entry level professional claims handler focused on workers’ compensation. The role handles medical and indemnity benefits, determining compensability and reserves as needed.

Responsibilities include verification of coverage, investigation of claims, and facilitating return to work while negotiating settlements within authority and ensuring compliance with state rules.