Senior Workers Comp Claims Adjuster- Must live in Iowa State

North American Risk Services (NARS); Iowa (LA); On-site; USD 65,000 - 85,000; Full time

Job summary

North American Risk Services (NARS) is seeking an experienced claims adjuster to manage a complex caseload and perform comprehensive coverage analyses, investigations, and settlements. The role includes coordinating medical care as appropriate, evaluating damages, and identifying potential fraud while overseeing vendor relationships and reserve analysis.

The ideal candidate will mentor other adjusters, support management on special projects, and be able to travel as needed to conferences or

Qualifications

• Experience handling complex property and casualty claims.
• Strong investigative and negotiation skills.
• Ability to mentor other adjusters.

Responsibilities

• Handle a caseload commensurate with the complexity level of claims assigned.
• Establish facts of loss, coverage analysis, investigation, compensability/liability/negligence determination, and settlement negotiations.
• Coordinate medical care when appropriate and manage damage assessment.
• Identify potential fraud and perform subrogation screening.
• Vendor management, reserve analysis, and timely report completion.

Job description

Handle a caseload commensurate with the complexity level of claims assigned. Requires establishing facts of loss, coverage analysis, investigation, compensability/liability/negligence determination, coordination of medical care (as appropriate), litigation management, damage assessment, settlement negotiations, identifying potential fraud, vendor management, reserve analysis, and report completion. Ability to attend conferences, client meetings, mentor other adjusters and assist management as needed. Ensure compliance with state statutes, client guidelines and NARS Best Practices. Address claim metrics in a timely and appropriate manner. Perform other miscellaneous duties as assigned, which may include travel.

Essential Duties and Responsibilities:

Coverage:

• Identify, analyze, and confirm coverage.

Customer Service/Contact:

• Make contact first within parties and clients within eight (8) business hours.


• Communicate with parties and providers to determine liability, compensability, negligence, and subrogation potential.


• Obtain necessary information and explain benefits as appropriate. Maintain regular contact throughout the life of the claim process.


• Answer phones, check voice mail regularly, and return calls as needed.


• Assist with training/mentoring of Claims Adjusters.


• Assist management when required with projects or leadership as requested.


• Support management and handle various duties/responsibilities of the Assistant Unit Manager/Unit Manager as delegated in their absence.

Subrogation:

• Refer all files identified with subrogation potential to the subrogation department.


• Maintain closing ratio as dictated by management team.


• Close all files as appropriate in a timely and complete manner.


• Verify facts of loss and pertinent claims facts such as employment, wages, or damages and establish disability with treating physicians as appropriate