Claims Adjuster - Workers Compensation
eTeam Inc
Job Title: Claims Adjuster - Workers Compensation Job Location: Las Vegas, NV 89129 REMOTE Duration: 03 Months Contract Manager's note:
- Work location: remote or onsite, we prefer on site but if the candidate is experienced and licensed in NV, we are open to remote.
- NV license mandatory.
- Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
- Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
- Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding is correct.
- May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Maintains professional client relationships.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
- Bachelor's degree from an accredited college or university preferred.
- Four (4) years of claims management experience or equivalent combination of education and experience required.
- Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skill
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
Vacancy posted 2 days ago
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