Work Comp Medical Only Claims Adjuster

Frankenmuth Insurance; United States; On-site; USD 55,000 - 75,000; Full time

Job summary

Frankenmuth Insurance is seeking an experienced Claims Adjuster to investigate, evaluate, and resolve general property, casualty, and workers' compensation claims under moderate supervision. You will determine liability, applicable coverage, and reserves while maintaining compliant, high-quality service for policyholders and agents.

The role requires an Adjuster license, GA experience, and the ability to work legally in the United States.

Qualifications

• Requires valid Adjuster license and experience handling property/casualty claims.
• Two to four years of related experience and/or training; or an Associate's degree.
• Legal work status in the United States; visa sponsorship not available.

Responsibilities

• Investigates claims to determine liability and coverage.
• Obtains information from agents, insureds, claimants, and witnesses.
• Reviews documentation and prepares claim reports.
• Maintains reserves and monitors outcomes through audits.
• Delivers customer service to policyholders and agents.
• Interact with insureds, attorneys, and service providers as needed.
• May participate in settlements and attend conferences or trials.

Skills

Adjuster License

GA Experience

Education

Associate's degree (A.A.)

Job description

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

• Adjuster License.
• Experienced in GA.

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 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.
• 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 4: Two to four years related experience and/or training; or associate's degree (A.A.) from two-year college/technical school; 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.