Workers' Comp Claims Adjuster II – Complex Injury Resolution

MARTA (Metropolitan Atlanta Rapid Transit Authority); Atlanta (GA); On-site; USD 44,000 - 66,000; Full time

Job summary

MARTA is seeking a Claims Analyst to process, investigate, negotiate, and resolve complex Workers’ Compensation claims. The role involves determining diagnosis, treatment, prognosis, and compensability of workplace injuries with minimal supervision.

Under general direction, the position performs major assignments that affect business operations and may guide lower-level adjusters. The role requires strong analytical, negotiation and documentation skills.

Qualifications

• Bachelor's degree plus two years experience in the administration, negotiation, adjudication, and resolution of Workers’ Compensation claims.
• Experience with Georgia self-insurer preferred.
• In lieu of a degree, directly related experience may be substituted year-for-year.

Responsibilities

• Obtains information necessary to determine the Authority's legal liability in the most complex bodily injury, personal injury or property damage cases through observations of physical sites, interviews with witnesses, and reviews of medical and/or police reports.
• Evaluates findings and prepares written reports documenting conclusions and recommending actions based on an analysis of the evidence.
• Determines liability and extent of damages (property and/or personal), recommends monetary settlement, if applicable, and negotiates with claimant.
• Ensures that scheduled payments are made on a timely basis and in compliance with all applicable rules, regulations, and/or conditions governing each specific claim; ensures that all claim records and files are properly maintained.
• Provides information and assistance to the General Counsel in the resolution of claims under litigation.
• Provides guidance, coordination, training, and direction to lower level claims adjusters in the resolution of claims.
• Carries out major assignments in conducting the operations of the business.
• Performs work that affects business operations to a substantial degree.
• Maintains diary review of claim files.
• Performs other related duties as assigned.

Skills

Negotiation

Investigation

Documentation

Analytical thinking

Communication

Education

Bachelor's degree in Risk Management, Insurance, Business Administration or related field

Job description

MARTA is seeking a Claims Analyst to process, investigate, negotiate, and resolve complex Workers’ Compensation claims. The role involves determining diagnosis, treatment, prognosis, and compensability of workplace injuries with minimal supervision.

Under general direction, the position performs major assignments that affect business operations and may guide lower-level adjusters. The role requires strong analytical, negotiation and documentation skills.