Workers Comp Claims Adjuster- Remote

Illinois Association of Mutual Insurance Companies; Rolling Meadows (IL); Remote; USD 65,000 - 80,000; Full time

Job summary

Join a forward-thinking organization as a Workers Comp Claims Adjuster, where your expertise will directly impact the resolution of claims. In this remote position, you will manage medical-only claims, ensuring timely and fair resolutions while adhering to industry standards. Your analytical skills and effective communication will be crucial as you interact with insureds, claimants, and medical providers. This role offers a competitive salary and the opportunity to work in a dynamic environment that values critical thinking and problem-solving. If you have Illinois experience and a passion for making a difference in the insurance industry, this position is for you.

Qualifications

• One year related claims experience is a plus.
• Extensive knowledge of industry standards and practices.

Responsibilities

• Manage medical only claims from receipt to conclusion.
• Document files to support decisions and actions taken.

Skills

Critical Thinking

Problem Solving

Negotiation

Effective Communication

Analytical Skills

Education

College Degree

Tools

Claims Management Software

Job description

Workers Comp Claims Adjuster

Remote Position

Salary: 65k-80k, commensurate with experience

Illinois experience is required

Job Summary

The Workers Comp Claims Adjuster determines the extent and legitimacy of claims and issues benefits as jurisdictionally required.

Responsibilities:

1. Responsible for prompt and pro-active management of medical only claims from time of receipt to conclusion of claim to ensure timely, fair, and cost-effective resolutions. This includes timely contacts with insureds, claimants, and medical providers; making compensability determinations; paying wage loss benefits; issuing jurisdictional appropriate forms and EDI transactions; evaluating injuries and treatment plans.
2. Properly reserves funds. Adjusts reserves timely and appropriately as the facts of the claim change.
3. Reviews and maintains claim system diaries.
4. Properly documents files to support decisions and actions taken pursuant to applicable Best Practices.
5. Follows company policies and procedures with respect to all essential duties and responsibilities of the job.
6. Follows client specific special handling instructions.
7. Effectively communicates in a professional manner both verbally and written.
8. Prepares claim summaries and attends claim reviews and client meetings as needed.
9. Other duties as assigned.

Qualifications:

1. College degree preferred.
2. One year related claims experience is a plus.
3. Extensive knowledge of accepted industry standards and practices. Computer experience with related claims and business software.
4. Illinois experience is required.

Work Traits:

1. Ability to think critically, solve problems, plan, and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.
2. Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses.
3. Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation.

Eligibility Requirements:

1. Interested candidates must submit a resume/online to be considered.
2. Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation.
3. Must be willing to execute Employee Agreement or Confidentiality/Non-Disclosure Agreement which requires, among other things, post-employment obligations relating to non-solicitation, confidentiality, and non-disclosure.

We offer a competitive salary plus benefits.