About the role
- Manage an inventory of medical only and lost time claims
- Plan and conduct claim investigations to confirm coverage and determine liability, compensability and damages
- Analyze and negotiate appropriate claim settlements/reserves within prescribed authority
- May attend arbitrations, mediations, depositions, or trials
- Convey information regarding coverage and settlements to insureds, claimants, and external partners
- Authorize payments within assigned authority limits and ensure timely payments
- Maintain accurate and detailed claim files, including correspondence, reports, and settlement agreements
- Ensure compliance with all state reporting requirements
- Follow medical treatment guidelines and utilize vendors to ensure proper treatment and care
- Perform other duties as assigned
Requirements
- Bachelor’s Degree recommended but not required
- Equivalent experience in Risk Management and Insurance or related field preferred
- Completion of or continuing progress toward a professional designation preferred (Associate in Claims (AIC), CPCU)
- Generally, 5+ years of experience in worker’s compensation claims handling
- Active adjuster licensing required
- California claim handling preferred but not required
- Excellent analytical, communication, negotiation, and problem-solving skills
- Strong knowledge of insurance policies, coverage, and claims handling procedures
- Knowledge of industry laws and regulations
- Advanced ability to organize and prioritize caseloads
- Excellent interpersonal skills and ability to build relationships and lead negotiations
- Proven ability to handle confidential information with discretion
- Competitive Total Rewards package
- Medical, dental, and vision plans starting on day one
- PTO
- Paid holidays
- Commuter benefits
- Employee stock purchase plan
- Education reimbursement
- Paid parental leave/adoption assistance
- 401(k) plan with company match
- Benefits available to eligible full-time and part-time employees
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims handlingclaim investigationsnegotiationsettlement analysisliability determinationcoverage analysismedical treatment guidelinesrisk managementinsurance policiesconfidential information handling
Soft skills
analytical skillscommunication skillsproblem-solving skillsinterpersonal skillsrelationship buildingorganizational skillsprioritizationleadershipnegotiation skillsdiscretion
Certifications
Associate in Claims (AIC)CPCUactive adjuster licensing