Senior Claims Adjuster

LEI Cross Financial Corp; Augusta (ME); On-site; USD 50,000 - 70,000; Full time

Job summary

The Cross Family of Agencies seeks a Claims Adjuster in Maine to manage workers' compensation claims within the Claims Management Division. The candidate should have a high school diploma (BA/BS preferred) and at least 3 years of relevant experience, plus an active Maine adjuster license.

Strong negotiation, analytical, and communication skills are essential. Responsibilities include accurate adjudication, payments, compliance with regulations, and collaboration with health providers, attorneys,

Qualifications

• High school graduate required; BA/BS degree preferred.
• Minimum 3 years Maine Workers' Compensation claim adjusting or paralegal experience.
• Maine Workers' Compensation adjusters’ license required.
• Strong organizational skills and ability to establish priorities; mathematical/accounting aptitude and analytical, problem-solving abilities.
• Strong interpersonal skills to interact with the public, customers and coworkers with tact and diplomacy.

Responsibilities

• Gains basic knowledge of Department Errors and Exposures and E&O Procedures.
• Ensures optimum performance and recommends techniques to increase productivity.
• Maintains image of corporate excellence and teamwork with emphasis on professional customer service.
• Accurately adjudicates claims by assessing information to determine compensability.
• Interfaces with Self Insured Management Team, claims management division personnel, insureds, health providers and attorneys; partners with employer in claims management.
• Reviews and authorizes payments.
• Complies with state mandates and contractual requirements; fosters courteous and supportive coworker relations.

Skills

Effective communication

Negotiation skills

Analytical problem solving

Multitasking

Presentation skills

Education

High school diploma

BA/BS degree preferred

Job description

The Cross Family of Agencies welcomes you. We need your talent and expertise. POSITION: Claims Adjuster DEPARTMENT: Claims Management Division REPORTS TO: Manager - Claims Management Division

Position Requirements:

• High school graduate required; BA/BS degree preferred.
• Minimum 3 years Maine Workers' Compensation claim adjusting or paralegal experience necessary.
• Maine Workers' Compensation adjusters’ license required.
• Highly developed organizational skills and ability to establish priorities. Mathematical/accounting aptitude and excellent analytical, problem-solving abilities required. Ability to anticipate needs and exercise independent judgment.
• Strong interpersonal skills to deal effectively with all levels of the organization, the public and customers with tact and diplomacy

Primary Accountabilities:

• Gains basic knowledge of Department Errors and Omissions Exposures and implementation of Department E&O Procedures.
• Ensures optimum performance in this function and recommends and implements techniques to increase productivity or department procedures.
• Develops and maintains an image of corporate excellence and teamwork with emphasis on professional and credible customer service and company relations.
• Accurate claims adjudication by assessing all information to determine compensability:
• Effective communication and negotiation skills
• Creative analytical problem solving skills
• Ability to manage multiple priorities in a fast paced and dynamic environment
• Ability to speak and present to various sized groups
• Interfaces with Self Insured Management Team, claims management division personnel, insureds, health providers and attorneys. Partners with employer in effective claims management.
• Reviews and authorizes payments.
• Complies with all state mandated and contractual requirements. . Positive and effective co-worker relations: Focus on team goals and objectives Courteous and considerate communications Accurate assistance and support to others as needed.

Family Owned

From starting at the kitchen table of Woodrow Cross, to becoming one of the largest insurance providers in New England, we’ve grown rapidly over the past 65 years. We’ve still held on to our core values of integrity, hard work, and dedication, and are still privately held. Our offices inspire a culture of community by supporting causes they stand behind. From fundraising for local food banks, to volunteering at after school programs, we’re proud of the many ways our offices find to give back. Initiatives vary from branch to branch to better serve the individual communities they are located in.