Workers’ Compensation Senior Claims Adjuster

Workers’ Compensation Senior Claims Adjuster

The James Allen Companies Inc.

Job Title: Workers’ Compensation Senior Claims Adjuster (Longshore and DBA)
Reports To: Senior Vice President
Position Type: Full Time, Exempt
Travel Requirements: Up to 10% annually

Job Summary:

The Senior Claims Adjuster will investigate, evaluate, dispose, and settle the most complex claims and highest exposures in an autonomous environment. This includes the investigation, determination and evaluation of coverage, compensability, and reserving. This role will include supervising and mentoring staff in the Seattle office as well as client account representative responsibilities.

Who is the Ideal Candidate?

The ideal candidate for this role should have a familiarity with standard concepts, practices, and procedures within the claims management field. They should possess the experience and judgment to interpret policies and procedures as established by senior management. This person should feel comfortable working autonomously and empowered to make decisions on goal planning. They should have the ability to understand written and oral communication and to interpret documents, such as workers’ compensation regulations and workers’ compensation forms, medical records, and legal reports.

Essential Duties & Responsibilities
• Exercise proper judgment and decision making to analyze the claims exposure, determine the proper course of action, and to appropriately resolve the claim.
• Interact extensively with various parties involved in the claims process.
• Able to clearly communicate concise action plans for moving claims to conclusion.
• Demonstrate complete knowledge of handling claims arising under the federal workers’ compensation system.
• Process claims consistent with clients’ and corporate policies, procedures, and best practices and in accordance with statutory, regulatory, and ethical requirements.
• Demonstrate the ability to comply with carrier reporting and threshold requirements
• Able to maintain a timely diary and handle a full caseload, with proven ability to handle cases of increased severity.
Other Duties
• Perform other duties as required or directed.
• Serve as contact for 24-hour emergency on-call coverage, as assigned.

Core Competencies

• Proficiency in a variety of claims management concepts and practices and have knowledge of general insurance procedures and workers’ compensation benefits under the Longshore and Harbor Workers Act and/or Defense Base Act
• Experience managing a department and supervising claims adjusters and assistants
• Excellent time management and organizational skills and the ability to multitask
• Strong interpersonal skills and work co-operatively with others to achieve a common goal
• Must be comfortable making timely decisions and exhibit sound and accurate judgment
• Knowledge of Claims Management Systems and Microsoft Office Suite

Education and/or Experience
• 5-10 years related claims experience

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