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Claims Adjuster
1 week ago
Sedgwick Charlotte, United States**The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the 'Apply' option.** · Claims Adjuster - LiabilityIF YOU CARE, THERES A PLACE FOR YOU HERE · For a career path that is both challenging and ...
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Claims Adjuster
1 week ago
Sedgwick Charlotte, United States**Claims Adjuster - Workers Compensation** · **Claims Adjuster - Workers Compensation** · **The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the 'Apply' option.** · Claims Adjuster - Workers ...
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Claims Adjuster
2 days ago
Randstad Charlotte, United StatesJob Description · Job DescriptionAre you passionate about facilitating seamless transitions and ensuring customer satisfaction? Join our team as a Change of Ownership Associate and become an integral part of our operations. You will be able to provide clients with a seamless tran ...
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Claims Adjuster Trainee
1 week ago
National General Insurance Charlotte, United StatesJob Description · ** Ideal candidate will be located in Winston-Salem or Charlotte, NC area. The Trainee role will be an in-office opportunity. If you posses great analytical skills, multitasking abilities and can provide empathy during stressful situations, apply with us today T ...
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Claims Adjuster Trainee
6 days ago
National General Insurance Charlotte, United StatesJob Description · ** Ideal candidate will be located in Winston-Salem or Charlotte, NC area. The Trainee role will be an in-office opportunity. If you posses great analytical skills, multitasking abilities and can provide empathy during stressful situations, apply with us today T ...
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Claims Adjuster I or II
1 week ago
National General Insurance Charlotte, United StatesJob Description · **The Claims Adjuster role is available at either our Winston Salem or Charlotte, NC office locations. If you are ready to continue growing your career and utilize your experience as an adjuster. Apply with us today ** · Job Summary: · The Claims Inside Auto An ...
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Claims Adjuster I or II
1 week ago
National General Insurance Charlotte, United StatesJob Description · **The Claims Adjuster role is available at either our Winston Salem or Charlotte, NC office locations. If you are ready to continue growing your career and utilize your experience as an adjuster. Apply with us today ** · Job Summary: · The Claims Inside Auto An ...
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Senior Workers Compensation Claims Adjuster
4 hours ago
Gallagher Charlotte, United StatesAbout Us: Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organizat ...
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Senior Workers Compensation Claims Adjuster
2 weeks ago
Gallagher Charlotte, United StatesAbout Us: Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organizat ...
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Lost Time Claims Adjuster II
3 weeks ago
PMA Companies Charlotte, United StatesAs a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest ris ...
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Claims Adjuster Trainee, I, II
2 weeks ago
National General Holdings Corporation Charlotte, United StatesStudies and successfully completes the Claims Training Program including but not limited to company orientation, company prepared training programs, outside courses as deemed appropriate, and on-the-job training. There is close supervisory review of Claims, Adjuster, Trainee, Cus ...
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Senior Workers Compensation Claims Adjuster
1 week ago
Gallagher Charlotte, United StatesAbout Us: · Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organi ...
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Lost Time Claims Adjuster I
2 weeks ago
PMA Companies Charlotte, United StatesAs a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest ris ...
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Senior Lost Time Claims Adjuster
3 weeks ago
PMA Companies Charlotte, United StatesAs a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk manag ...
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Senior Workers Compensation Claims Adjuster
1 week ago
Gallagher Charlotte, United StatesAbout Us: · Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organi ...
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Lost Time Claims Adjuster I
2 weeks ago
PMA Companies Charlotte, United StatesJob Description: · As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and ...
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Sr. Workers Compensation Claims Adjuster
3 days ago
Insurance Relief Charlotte, United StatesSr. Workers Compensation Claims Adjuster - Remote - Sacramento, CA · *Candidates must reside in California* · Are you seeking a career where you can better assist people and help support a strong team? A well-established TPA needs your help to support its ambitious team. Join a ...
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Claims Adjuster Trainee, I, II
2 weeks ago
National General Insurance Charlotte, United StatesJob Description · ** Ideal candidate will be located in Winston-Salem or Charlotte, NC area. The Trainee role will be an in-office opportunity. If you posses great analytical skills, multitasking abilities and can provide empathy during stressful situations, apply with us today T ...
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Claims Adjuster Trainee, I, II
3 weeks ago
National General Insurance Charlotte, United StatesJob Description · ** Ideal candidate will be located in Winston-Salem or Charlotte, NC area. The Trainee role will be an in-office opportunity. ** · Primary Purpose: · Studies and successfully completes the Claims Training Program including but not limited to company orientation ...
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Claims Adjuster Trainee, I, II
2 weeks ago
National General Charlotte, United States Full time** Ideal candidate will be located in Winston-Salem or Charlotte, NC area. The Trainee role will be an in-office opportunity. ** · Primary Purpose: · Studies and successfully completes the Claims Training Program including but not limited to company orientation, company prepared ...
Senior Lost Time Claims Adjuster - Charlotte, United States - PMA Companies
Description
As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes.
In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.
Responsibilities:
Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature
Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)
Alert Supervisor and Special Investigations Unit to potentially suspect claims
Ensure timely denial or payment of benefits in accordance with jurisdictional requirements
Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure
Negotiate claims settlements with client approval
Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition
Work collaboratively with PMA nurse professionals to develop and execute return to work strategies
Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome
Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced
Demonstrate technical proficiency through timely, consistent execution of best claim practices
Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues
Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions
Authorize treatment based on the practiced protocols established by statute or the PMA Managed Care department
Assist PMA clients by suggesting panel provider information in accordance with applicable state statutes.
Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
At least 3-5 years' experience handling lost time workers compensation claims required; past experience with North Carolina jurisdiction is required
Associate in Claims (AIC) Designation or similar professional designation desired.
Active license required or ability to obtain license within 90 days of employment in mandated states.
Familiarity with medical terminology and/or Workers' Compensation
Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
Strong verbal, written communication skills and customer service skills
Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
Ability to travel for business purposes, approximately less than 10%.
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