Workers Compensation Adjuster

Questpro Consultants LLC; Atlanta (GA); On-site; USD 60,000 - 85,000; Full time

Job summary

Questpro Consultants LLC represents a growing MGA specializing in Workers' Compensation, seeking Lost Time Claims Adjusters in Atlanta. You will manage claims efficiently while delivering outstanding customer service, reporting to the Claims Manager, using negotiation and analysis to assess payable claims and ensure compliance.

Ideal candidate has 5 years of WC claims handling, at least 3 years Lost Time adjusting; must be fluent in English; Spanish a plus.

Qualifications

• 5 years of Workers' Compensation Claims handling.
• Lost Time adjusting for at least 3 years.
• Ability to solve practical problems and to work independently.
• Good interpersonal skills.
• Ability to build and maintain relationships with insureds, injured workers and attorneys.
• Fluent English is required. Spanish speaking is a plus.

Responsibilities

• Determining coverage on new claims.
• Contacting employer for initial investigation.
• Contacting employee for information — recorded statements.
• Reviewing medical bills to determine if payment is proper and referral of those bills for audit.
• Filing necessary forms with the Industrial Commission.
• Determining appropriate reserves for claims.
• Determining when claims need medical case management services and arranging the necessary care.
• Corresponding with attorneys on legal issues.
• Attending mediations and hearings.
• Preferred states for claims handling: NC, SC, GA, KY, TN

Skills

Workers' compensation claims

Lost Time adjusting

Negotiation

Analysis

Communication

Bilingual English/Spanish

Job description

Our client, a growing MGA that specializes in the Workers Compensation is looking for a couple of Lost Time Claims Adjusters. In this role, you will be essential in managing claims efficiently while providing outstanding customer service. Reporting to the Claims Manager, you will utilize your core skills in negotiation and analysis to assess claims and ensure compliance with workers’ compensation laws. As a Lost Time Claims Adjuster, you will be investigating claims, determining if the claim is payable and managing the care of the injured employee.

The ideal candidate will have:

• Ability to solve practical problems and to work independently.
• 5 years of Workers Compensation Claims handling. Lost Time adjusting for at least 3 years.
• Ability to be resourceful and prioritize.
• Good interpersonal skills.
• Ability to build and maintain relationships with insureds, injured workers and attorneys.
• Fluent English is required. Spanish speaking is a plus.

The main job responsiblities:

• Determining coverage on new claims.
• Contacting employer for initial investigation.
• Contacting employee/injured worker for information — recorded statements
• Reviewing medical bills to determine if payment is proper and referral of those bills for audit.
• Filing necessary forms with the Industrial Commission.
• Determining appropriate reserves for claims.
• Determining when claims need medical case management services and arranging the necessary care.
• Corresponding with attorneys on legal issues.
• Attending mediations and hearings.

Preferred states for claims handling: NC, SC, GA, KY, TN