Description
We are looking for an experienced Workers' Compensation Adjuster to join our team. You will investigate and evaluate losses, developing a plan to bring claims to proper resolution in a timely manner.
Davies North America is a leading provider of professional services and technology solutions.
Key Responsibilities
- Determine the extent of insurance coverage and compensability on each filed claim
- Investigate claims, including interviewing employees, employers, and witnesses
- Obtain necessary records, such as hospital records, police reports, and physician records
- Handle EDI and CMS/Section 111 reporting
- Utilize preferred vendors
- Present thorough and accurate reports to clients and/or carriers on claims investigations
- Negotiate settlements for resolutions with claimants and their attorneys
- Maintain control of litigation activities and costs per account requirements
- Mentor, train, and share expertise with other Davies staff
- Attend meetings, conferences, workshops, or training sessions to maintain current knowledge on principles, practices, and new developments
- Maintain specific licensing requirements
- Respond to client questions and comments in a courteous and timely manner
- Handle catastrophic losses, complex litigation, and sensitive issues
Skills, Knowledge & Expertise
- Understand and follow oral and written policies, procedures, and instructions
- Perform a wide variety of duties and responsibilities with accuracy and speed while meeting deadlines
- Conduct investigations in multi-party situations
- Use standard or customized software applications
- Prepare and present accurate, reliable, and factual reports with recommendations
- Have thorough knowledge of current principles and practices associated with claims investigations and adjustment
- Possess extensive knowledge of medical and legal terminology with a thorough understanding of legal principles and litigation management
- Handle confidential information
- Communicate effectively with others orally and in writing
- Learn quickly and utilize new skills due to rapidly changing information and technology
- Comprehend multi-state laws and regulations
Benefits
- Medical, dental, and vision plans
- 401(k) plan with employer matching
- Time-off policies, including Discretionary Time Off (DTO) and Paid Time Off (PTO)
- Paid holidays
- Life insurance and short-term and long-term disability coverage