Occupational Accident Lost Time Claims Adjuster / Workers Compensation Adjuster / Paralegal / L[...]

Blue Star Claims LLC; United States; On-site; USD 50,000 - 70,000; Full time

Job summary

A leading claims administrative company is seeking an Occupational Accident Claims Adjuster. This full-time entry-level position involves investigating claims, authorizing payments, and ensuring efficient claim resolution, all while providing excellent service to clients in the insurance sector.

Qualifications

• At least two years of experience in Occupational Accident claims adjusting or as a Paralegal/Legal Assistant.
• Experience with Microsoft Office.

Responsibilities

• Investigate and adjust occupational accident claims based on established procedures.
• Authorize payment of claims and manage claims to optimal resolution.
• Review medical records and communicate effectively with clients.

Skills

Microsoft Office

Job description

Occupational Accident Lost Time Claims Adjuster / Workers Compensation Adjuster / Paralegal / Legal Assistant

Occupational Accident Lost Time Claims Adjuster / Workers Compensation Adjuster / Paralegal / Legal Assistant

Blue Star Claims LLC is a Third-Party Administrator specializing in Occupational Accident Claims throughout the United States. This is an excellent opportunity to work in a growing and dynamic work environment. We believe in delivering a high-quality work product to our clients with emphasis on communication and service. We believe in providing an environment where employees enjoy coming to work every day, provide the resources needed to perform their job and assign manageable caseloads. The Occupational Accident Claims Adjuster is responsible for the investigation and adjustment of assigned Occupational Accident claims.

Essential Duties And Responsibilities

• Investigate and adjust occupational accident claims in accordance with established claims handling procedures using Blue Star guidelines and supervision.
• Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing occupational accident claims.
• Authorize and make payment of occupational accident claims utilizing our claim processing protocol in accordance with policy language and within authority levels.
• Process medically necessary and related bills according to Policy provisions
• Issue lost time (indemnity) benefits timely and according to Policy provisions
• Calculate lost-time (indemnity) rate appropriately based on earned income.
• Monitor return to work treatment plan and progress
• Make supported and educated claim decisions timely.
• Forecast potential exposure for reserving claims.
• Have continued contact with policyholders.
• Negotiate settlements, if appropriate pursuant to the terms of the policy and within authority levels
• Deliver quality claim service to clients and be responsive to client needs.
• Familiarize yourself with jurisdiction challenges you may face and be mindful of potential exposure.
• Manage your time efficiently and utilize your attention to detail to every claim you work on
• Use established forms and modify letters pursuant to Policy provisions.
• Review and document medical records outlining treatment plan, restrictions, and plan of action.
• Able to identify mechanism of injury vs symptoms vs non-related conditions.
• Policy review and administration of benefits pursuant to policy terms
• Manage claim to optimal resolution; paying for what we owe with relation to the policies we administer.
• Establish valuable relationships with our Insureds / Motor Carriers / Brokers / Providers / Preferred Vendors
• Work as a team player
• Be flexible, use initiative and work with minimum of direct supervision.
• Use discretion and confidentiality required.
• Clearly communicate verbally and/or in writing both internally and externally
• Be organized, a self-starter and prioritize your duties with attention to detail.
• Perform other duties as assigned.
  
  

Requirements

• At least two years of experience in Occupational Accident claims adjusting, Workers Compensation claims adjusting, or as a Paralegal/Legal Assistant in Workers Compensation.
• Microsoft Office experience
• Completion of our pre-employment assessment via the link below. https://www.ondemandassessment.com/link/index/JB-87PS9BLTA?u=93138

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Insurance

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