Associate Claims Adjuster, Workers' Compensation

Associate Claims Specialist

Under direct supervision, the Associate Claims Specialist develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. They will assist in providing service to policyholders/customers on mid-sized and/or large commercial accounts.

Responsibilities

• Investigates new claims by reviewing first reports of loss and supporting materials, determines the best first point of contact (claimants, customers, witnesses, etc.) to gather information regarding injuries or loss refers tasks to auxiliary units as necessary and posts file accordingly.
• Establishes action plans based on case facts, best practices, protocols, jurisdictional issues and available resources.
• Manages an inventory of property/casualty and disability claims (e.g. workers` compensation, general liability, commercial automobile, property, group benefits), evaluates compensability/liability and losses, and negotiates settlements within prescribed limits.
• Establishes accurate loss cost estimates using available resources, special service instructions, and market protocols.
• Confirms or denies coverage based on facts obtained during the investigation and advises policyholders as to proper course of action.
• Makes effective use of loss management techniques (e.g. Immediate Contact Plan, L9 check, Disability Management, open end release, first call settlements) and other resources.
• Updates files and provides comprehensive reports as required.

Qualifications

• Effective interpersonal, analytical and negotiation abilities required
• Ability to provide information in a clear, concise manner with an appropriate level of detail
• Demonstrated ability to build and maintain effective relationships
• Demonstrated success in a professional environment; success in a customer service/retail environment preferred
• Effective analytical skills to gather information, analyze facts, and draw conclusions; as normally acquired through a bachelor's degree or equivalent
• Knowledge of legal liability, insurance coverage and medical terminology helpful, but not mandatory
• Licensing may be required in some states

As part of the application process, you'll complete an assessment related to the skills needed for this role please allow approximately 35 minutes, although there is no time limit.