Liability Claims Adjuster Trainee

Job Title: Claims Adjuster Professional Trainee
Department: Claims
Reports to: Claims Manager
This position will be responsible, following the initial training phase, for the adjudication of all assigned claims in accordance with the Act, governing rules and regulations, related case law and company procedures. Case complexity assignment is determined by the responsible claims manager and is guided by the level of training and performance of the claims adjuster trainee candidate.
The Claims Professional Trainee position is designed to introduce the individual to the workers' compensation claims function of New Mexico Mutual over a one-year (1) period of time. This candidate will have access to a comprehensive and formal training program under the direct guidance and supervision of our claims training manager, with active participation from other claims management personnel and claims specialists.
This claim training will cover claim investigation, compensability, policy coverage, statutory law, case law, benefits analysis and payment, litigation, medical and claims resolution.
Responsibilities include effective and consistent partnership with the employer, injured worker and medical provider, administration of benefits, litigation management and claims resolution.
Verify claim information including but not limited to: documentation of the claim history; taking recorded statements from workers and witnesses, coordination of medical care.
Document all activities in the claim management system. Responsible for outside legal counsel assignments, RTW strategies & all other expert assignments.
Set and monitor reserves according to company policies and the worker's injury, issue benefit checks in accordance to statutory requirements, and demonstrate proficiency in the application of state statutes, related case law and to interpret and comply with company claims standards, policies and procedures.
Maintain a diary on all open claims. Document all relevant information to provide a clear history of events and a proper audit trail. Set review dates based on claim complexity or standard review criteria.
Bachelor's Degree from an accredited college or university.
No prior claims handling experience is necessary for this position.
MS Office (Word, Advanced Excel, PowerPoint, Outlook)
Develops and maintains positive working relationships with team members, customers, co-workers, and management by demonstrating effective communication and collaborative skills.
Employees of NEW MEXICO MUTUAL adhere to all safety rules and regulations including building security.
Employees participate in ensuring safe and efficient operating conditions that safeguard employees and facilities.
drug testing prior to employment as well as upon a work-related accident.