Senior Claims Adjuster
Trean Insurance Group
full-time
Posted on:
Location Type: Hybrid
Location: Ontario • California • United States
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Salary
💰 $85,000 - $95,000 per year
Job Level
About the role
- The Senior Claims Adjuster is responsible for managing complex workers compensation claims
- Ensure ongoing adjudication of claims within company standards and industry best practices
- Maintain compliance with statutory and regulatory requirements for the administration of workers compensation benefits
- Manage the legal aspects of the claim and appropriately assign and direct designated attorneys
- Ensure timely claims determinations for all services including acceptance, denials, authorizations for treatment, benefit payment start, termination within jurisdictional time frames
- Identify medical providers and ensure timely and appropriate medical care for injured workers
- Establish a Plan of Action (POA) on each claim and update it monthly
Requirements
- High school diploma or GED required
- Bachelor’s degree or equivalent experience preferred
- 5 or more years’ claims experience preferred
- Insurance industry knowledge required
- Excellent analytical skills and verbal and written communication skills
- Strong organizational skills
- Strong oral and written communication skills
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims managementworkers compensationadjudicationcompliancelegal aspects of claimsmedical care coordinationPlan of Action (POA)benefit payment processingstatutory requirementsregulatory requirements
Soft Skills
analytical skillsverbal communicationwritten communicationorganizational skillsinterpersonal skillsproblem-solvingattention to detailtime managementleadershipnegotiation
Certifications
high school diplomaGEDBachelor’s degree