Claims Adjuster - Workers Compensation
Philadelphia, Pennsylvania
Innovative employee friendly Claims’ Third Party Administrator(TPA) has a brand new opening due to growth for a customer centric Workers' Compensation Adjuster. Position will be full time (flexible M-F work schedule) conveniently located in their Northwestern Philadelphia Suburban Branch. Also offering discretionary work from home option (up to 2 days a week) after probationary period. File counts are kept to a minimum with helpful Administrative staff and user friendly efficient software systems. Qualified Applicants MUST have direct Lost Time Claims handling experience handling PA &/or surrounding neighboring states. DE License is a plus BUT not required. Competitive, Salary & Benefit plan.
General Description:
Manage within company standards and best practices complex and problematic high visibility workers' compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim.
Essential Job Duties:
Receives claim, confirms policy coverage & acknowledgement of claim
Determine validity & compensability of claim by investigating & gathering info, file necessary documentation with state agencies
Establish reserves & authorize payments within reserving authority limits
Develop and manage well documented action plan with case manager, attorney, supervisor & client to reduce overall cost of claim
Coordinating early return to work efforts with case manager & employer
Negotiates settlements when necessary
Actively manage the litigation process
Identifies potential subrogation claims
Communicate claim status with customer and claimant
Adhere to client guidelines & participate in claim reviews as needed
Develops & maintains professional customer relationships
Education/Training Requirements:
Degree at an accredited college or university preferred
Excellent oral, written communication skills & customer service
PC literate, including Microsoft Office (Word, Excel)
Effective analytical & interpretive skills
Strong organizational skills
JOB OVERVIEW