Workers Comp Claims Adjuster

Ruan; Des Moines (IA); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Ruan is hiring a Work Comp Claims Adjuster to join our Des Moines team, offering a hybrid schedule with on-site work at our downtown campus and remote work options.

The role requires at least one year of Work Comp claims adjuster experience, with 3+ years preferred, and focuses entirely on workers' compensation claims. You will analyze, investigate, evaluate, and resolve claims while ensuring regulatory compliance and accurate documentation.

Qualifications

• Must have Work Comp claims adjuster experience.
• Bachelor's degree or equivalent work experience.
• 3–5 years of claims experience preferred.

Responsibilities

• Investigate workers' compensation, interview or correspond with all parties to the loss, review documents to determine damages.
• Determine if additional services are needed and provide referrals: environmental services, independent adjuster, nurse case manager, and legal counsel.
• Oversee the action of the third party administrator to ensure compliance with Ruan's claim handling instructions.
• Recommend acceptance or denial of claim within authority.
• Oversee negotiations with claimant or injured worker for potential claim settlement within authority.
• Collaborate with internal and external legal counsel if contested; support in legal proceedings as needed.
• Maintain file documentation and all required reports including OSHA, DOT, and post-accident testing.
• Monitor for appropriate claim reserves and adjust as necessary.
• Pursue subrogation when appropriate.

Skills

Communication

Analytical skills

Negotiation skills

Legal/claims knowledge

Education

Bachelor's degree or equivalent

Associate in Claims designation preferred

Job description

Ruan is now hiring a Work Comp Claims Adjuster to join our team!

This is a hybrid role offering mix of on-site work at our downtown Des Moines campus and remote work.

At least one year of Work Comp claims adjuster experience is required; 3+ years experience is preferred.

This claims adjuster position works 100% on work comp claims.

Responsible for the analysis, investigation, evaluation, and resolution of workers' compensation.

Responsibilities:

Carrying out the Company's organizational values and operating in accordance with applicable laws, regulations, and Company policies are required functions. Essential and other important responsibilities and duties may include, but are not limited to, the following:

• Investigate workers' compensation. Interview or correspond with all parties to the loss. Examine photographs, surveillance video, statements, medical records, and other supporting documents to determine damages. If necessary, consult with law enforcement to determine liability.
• Determine if additional services are needed to bring the claim to resolution and provide appropriate referrals: environmental services, independent adjuster, nurse case manager, and legal counsel.
• Oversee the action of the third party administrator to ensure compliance with Ruan's claim handling instructions.
• Recommend acceptance or denial of claim within authority.
• Oversee negotiations with claimant or injured worker for potential claim settlement within authority.
• If claim is contested, collaborate with internal and external legal counsel to defend Ruan's position. Produce documentation to support Ruan's position. May require participation in legal proceedings.
• Maintain file documentation and all required reports; including OSHA, DOT, and post-accident drug and alcohol testing.
• Monitor for appropriate claim reserves. Make recommendations for adjustments as necessary.
• Protect and pursue subrogation when appropriate.
• Perform other job-related duties and special projects as required.

Requirements

Job Requirements/Minimum Qualifications:

Education: Bachelors Degree or equivalent work experience

Course(s) of Study: Business or related field of study; Associate in Claims designation preferred

Experience: 3-5 years is preferred

Type of Experience: Claims Experience

Required Knowledge, Skills and Abilities:

• Must be able to commit to Ruan's value statement by acting with integrity in everything we do.
• Must be able to meet behavioral expectations and perform in alignment with our guiding principles: safety, people, customer, performance, and continuous improvement.
• Strong verbal and written communication skills. Demonstrates attention to detail and sense of urgency. Ability to set priorities and accomplish duties of position with minimal direction. Strong analytical, decision making, and negotiating skills. Demonstrated ability to determine liability/responsibility based on various workers' compensation and negligence statutes (comparative, contributory, etc.) at the local, state, and federal levels. Ability to communicate with all levels of management within the company. Willingness to maintain professional and technical knowledge through continuing education.

Ruan provides benefits which include: Medical, Dental, Vision, Disability, Life, as well as 401k and Paid Time off.

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