Workers Compensation Claims Adjuster

Workers Compensation Claims Adjuster

The James Allen Companies Inc.

Workers Compensation Claims Adjuster

About the job

Company Description:

Our client is a Michigan based insurance company that has been providing workers’ compensation insurance to employers throughout Michigan since 1976.

Role Description:

This is a full-time role for a Claims Adjuster. The Claims Adjuster will be responsible for handling the daily processing of insurance claims, including determining coverage, investigating claims, and adjusting and managing claims within a team. The Claims Adjuster will also be responsible for assisting insureds, cultivating good customer relations, and answering insured or claimant questions. This is an on-site role located in Novi, MI

Essential Duties:

  • Investigate, adjust, and conclude workers’ compensation claims in a timely manner.
  • Assist insureds and cultivate good customer relations by performing the following duties:

. Examine policy to verify coverage

. Investigate cause of loss and document information in the file

. Obtain evidence if fraud or subrogation is involved

. Establish reserves and review current reserves for accuracy

. Review medical & investigative reports and apply finding to the claim

. Perform three point contact

. Apply benefits within scope of the Michigan workers’ compensation act

. Prepares properly documented file for data entry and payment issuance

. Answer questions from insureds/claimants regarding the claims process

. Discuss claims above authority, and submits authority reporting to Vice President of Claims

. Performs other related duties as assigned or directed by the President or Vice President of Claims

. Actively pursues continuing education

Qualifications:

  • Claims handling and insurance skills
  • 3+ years of experience in workers’ compensation claims adjusting
  • Claims management skills – medical only and indemnity cases
  • Excellent written and verbal communication skills
  • Ability to work independently and in a team environment
  • Ability to utilize multiple claims management software
  • Insurance adjuster license is preferred
  • Litigation experience is preferred

Benefits:

  • Health, Dental, Vision, and Life Insurance
  • 401k
  • Paid Time Off
  • Max. file size: 300 MB.
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