Senior Workers' Comp Claims Adjuster - Hybrid Role

Elite Tek Services, Inc.; Denver (CO); Hybrid; USD 80,000 - 90,000; Full time

Job summary

Elite Tek Services, Inc. is seeking an experienced workers’ compensation claims professional to manage a busy caseload and ensure timely investigations and adjudication.

The role involves determining compensability, authorizing medical treatment, calculating reserves, and maintaining clear communication with claimants, providers, and clients while adhering to company guidelines and state laws. Hybrid work arrangement mentioned.

Qualifications

• High School Diploma or GED required.
• Bachelor’s degree in related field preferred.
• Two years related experience preferred.
• Equivalent combination of education and experience.

Responsibilities

• Manages an active caseload of workers’ compensation files (150+).
• Initiates and conducts claims investigation in a timely manner.
• Determines compensability of claims and administers benefits per state law and guidelines.
• Manages medical treatment and medical billing, authorizing as needed.
• Communicates with claimants, providers and vendors regarding claims issues.
• Computes and sets reserves within Company guidelines.
• Maintains diary system for case review and status tracking.
• Reports to clients on claim status and injury trends.
• Adheres to Company policies and procedures.
• Participates in file reviews with clients; handles other jurisdictional claims as needed.

Skills

Analytical skills

Written communication

Verbal communication

Interpersonal skills

Education

High School Diploma or GED

Bachelor’s degree

2 years related experience

Equivalent education/experience

Tools

MS Word

Excel

Job description

Elite Tek Services, Inc. is seeking an experienced workers’ compensation claims professional to manage a busy caseload and ensure timely investigations and adjudication.

The role involves determining compensability, authorizing medical treatment, calculating reserves, and maintaining clear communication with claimants, providers, and clients while adhering to company guidelines and state laws. Hybrid work arrangement mentioned.