Lost-Time Claims Adjuster

SteadPoint; Birmingham (AL); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Competitive Salary

401(k)

Health & Dental

Supplemental Health

Vision Insurance

PTO

Life Insurance

Continuing Education

Designation Sponsorship

Job summary

SteadPoint is seeking a Lost-Time Claims Adjuster to administer and manage workers' compensation claims from initial report through closure. The role requires evaluating compensability, conducting investigations, obtaining statements, coordinating medical treatment, and facilitating return-to-work efforts.

The ideal candidate will demonstrate strong analytical, negotiation, and organizational skills, with a focus on timely, compliant resolutions and maintaining professional relations with

Qualifications

• Bachelor's degree with 5+ years of experience, or 10+ years without a degree.
• Knowledge of state workers' compensation laws.
• Experience within Core Footprint (AL, GA, MS, TN, AR, NC, SC) and willingness to learn new jurisdictions.
• Equivalent insurance claims experience.
• Workers' Compensation experience.

Responsibilities

• Manage a large inventory of complex claims to evaluate compensability/liability.
• Analyze and negotiate appropriate claim settlements and reserves within authority.
• Convey complex information regarding coverage and settlements to insureds, claimants, and external partners.
• Authorize payments within assigned authority and ensure timely processing.
• Maintain detailed claim files and documentation.

Skills

State law knowledge

Core footprint experience

Claims handling

Workers' comp experience

Communication skills

Education

Bachelor's degree (or equivalent) with 5+ years

10+ years experience without degree

Job description

SteadPoint has been a trusted workers' compensation partner for years. We're known for being reliable, responsive and eager, and for making the workers' compensation system as easy as possible for agents, employers and employees. We care deeply about people and serve them with excellence, integrity and passion. We value our team members and provide a welcoming, inclusive and supportive workplace where they can maximize their talents and achieve their personal and professional goals. Our Core Footprint is in the following states, MS, AR, AL, TN, GA, NC, and SC.

POSITION AVAILABLE - LOST-TIME CLAIMS ADJUSTER

The Claims Adjuster with SteadPoint Risk Management Solutions is responsible for administering and managing workers' compensation claims from initial report through closure. This includes evaluating compensability, conducting thorough investigations, obtaining recorded statements from claimants and witnesses, coordinating medical treatment, facilitating return-to-work efforts, assigning legal counsel when appropriate, and overseeing the delivery of workers' compensation benefits. The Claims Adjuster ensures claims are handled efficiently, accurately, and in compliance with applicable regulations, industry standards, and company guidelines.

This position operates with a high degree of independence and authority while handling claims involving significant complexity and specialized technical expertise. Responsibilities include evaluating claim exposure, establishing and maintaining appropriate reserves, directing claim strategy, and guiding claims toward timely resolution or settlement. The Claims Adjuster must possess a thorough understanding of insurance coverage, claims administration practices, medical terminology, and applicable laws, regulations, and case law that may impact claim outcomes.

Success in this role requires exceptional analytical, negotiation, decision-making, and problem-solving skills, along with the ability to effectively organize and prioritize a diverse caseload. The Claims Adjuster must build and maintain productive relationships with claimants, clients, medical providers, attorneys, and other stakeholders through strong interpersonal and communication skills. This individual handles sensitive and confidential information with professionalism and discretion, serves as a trusted technical resource within the Claims Department, and provides guidance and support to team members as needed. A commitment to following established company policies, procedures, and evolving business practices is essential.

JOB FUNCTIONS AND RESPONSIBILITIES

• Manage a large inventory of complex claims to evaluate compensability/liability.
  Plans and conducts complex claims investigations to confirm coverage and to determine liability, compensability and damages.
• Analyzes and negotiates appropriate claim settlement/reserves within prescribed authority. May
  attend arbitrations, mediations, depositions, or trials.
• Conveys complex information regarding coverage and settlements to insureds, claimants, and external partners.
• Authorizes payments in accordance with assigned authority limit and ensures payments are made
  in a timely manner.
• Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.
• Receipt, review, and analyze incoming claims.
• Produce necessary documentation for justification of compensability and/or denial of claim.
• Must be able to answer, service, and document calls pertaining to policy benefits and determine whether the call needs to be referred to a supervisor.
• Take statements of injured worker, insured, potential witnesses, as necessary, in the scope of
  investigative duties of the claim.
• Process lost time benefits and coordinate meds, assign nurse case management, assign legal
  counsel if deemed necessary, and/or surveillance when appropriate.
• Coordinate, review & ensure compliance to all state WC Board, EDI, CMS, NCCI, etc. reporting.
• Assign independents and experts for onsite inspection and expert opinions regarding potential subrogation possibilities on serious claims.

SKILLS & QUALIFICATIONS

• Preferred bachelor's degree with 5years' experience or 10 years' experience without a degree
• Knowledge of applicable state laws relating to workers' compensation
• Experience within Core Footprint (AL, GA, MS, TN, AR, NC, & SC) and willingness to learn new
  jurisdictions
• Equivalent insurance claims
• Workers' Compensation experience

BENEFITS INCLUDE

• Competitive Salary
• 401(k)
• BCBS Health & Dental
• Supplemental Health Policy
• VSP Vision Insurance
• PTO
• Life Insurance
• Continuing Education
• Designation Sponsorship