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Work Comp Claims Adjuster

Work from home Full-time role Hiring

Workers Compensation Claims Investigator Looking for someone with wage loss experience in the states of IL/MI/IN. This position has the ability to work remotely. Summary: Under general supervision and following standard procedures with independent judgment, investigates, evaluates and resolves/disposes of workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage, compensability, and liability in accordance with policy provisions by performing the following duties. Essential Duties and Responsibilities:

  • Follows corporate policies, procedures, and fair claims handling practices
  • Investigates claims to determine validity and extent of liability, including:
  • Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others
  • Reviews and evaluates documentation, including applications, reports, and statements
  • Monitors appropriate claim outcomes through self-audit process
  • Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues
  • Ensures legal, regulatory and fair claims handling compliance
  • Sets or recommends reserves based on results of claim investigation.
  • Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports.
  • May provide extensive interaction with insureds, agents, claimants, attorneys, and other service providers, including:
  • Conducts in-depth interviews and/or scene inspections
  • Attends settlement conferences and/or trials
  • May serve as a member of project teams, contributing to the achievement of project objectives.
  • Performs other duties as assigned.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience: Level 4: Two to four years related experience and/or training; or associate's degree (A.A.) from two-year college/technical school; or equivalent combination of education and related experience/training. A minimum requirement for this position is the ability to work legally in the United States. No visa sponsorship/support is available for this position, including for any type of U.S. permanent residency (green card) process.

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