Work Comp Claims Adjuster

Frankenmuth Insurance Company; United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Frankenmuth Insurance Company seeks a Wage Loss Experience Specialist to investigate, evaluate and resolve workers' compensation claims with limited supervision. You will determine liability, review documentation, and prepare claim reports while ensuring policy provisions and regulatory compliance.

Responsibilities include interviewing insureds and witnesses, setting reserves within authority, and collaborating with agents and attorneys to achieve timely resolutions.

Qualifications

• Bachelor's degree or equivalent in a related field or equivalent combination of education/training.
• Four to six years related experience and/or training in wage loss/claims handling or workers' compensation.
• Strong ability to investigate, evaluate, and determine liability and coverage.

Responsibilities

• Investigates claims to determine validity and extent of liability, including obtaining information from agents, insureds, claimants, witnesses, and others.
• Reviews and evaluates documentation such as applications, reports, and statements; prepares claim reports.
• Sets or recommends reserves based on investigation results; concludes claims within defined authority.
• Interacts with insureds, agents, claimants, attorneys, and service providers; conducts interviews and scene inspections as needed.
• Ensures legal, regulatory, and fair claims handling compliance.

Education

Bachelor's degree or equivalent

Four to six years related experience

Job description

LOOKING FOR SOMEONE WITH WAGE LOSS EXP IN GA, NC, SC, TN, KY**

LOOKING FOR SOMEONE WITH WAGE LOSS EXP IN GA, NC, SC, TN, KY**

Summary: Under limited supervision and with independent judgment, investigates, evaluates and resolves/disposes of workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage and compensability liability in accordance with policy provisions by performing the following duties.

Essential Duties And Responsibilities

• Follows corporate policies, procedures, and fair claims handling practices
• Investigates claims to determine validity and extent of liability, including:
  • Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others
  • Reviews and evaluates documentation, including applications, reports, and statements
  • Monitors appropriate claim outcomes through self-audit process
  • Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues
  • Ensures legal, regulatory and fair claims handling compliance
• Sets or recommends reserves based on results of claim investigation.
• Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports.
• May provide extensive interaction with insureds, agents, claimants, attorneys, and other service providers, including
  • Conducts in-depth interviews and/or scene inspections
  • Attends settlement conferences and/or trials
• May serve as a member of project teams, contributing to the achievement of project objectives.
• Provides leadership to junior staff by training and providing guidance. May provide input to management regarding junior staff performance.
• Performs other duties as assigned.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience

Level 5: Four to six years related experience and/or training; or bachelor's degree (B.A.) from four-year college/university; or equivalent combination of education and related experience/training.

A minimum requirement for this position is the ability to work legally in the United States. No visa sponsorship/support is available for this position, including for any type of U.S. permanent residency (green card) process.