Claims Representative managing insurance claims for Great American Insurance Group. Evaluating liability and negotiating settlements while working in a hybrid model from Cincinnati, OH.
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Hybrid Workers Compensation Claims Adjuster, III
Posted 9 hours ago
About the role
- Claims Adjuster managing complex workers' compensation claims for AvonRisk. Ensuring timely and effective case management with a focus on solutions and collaboration.
Responsibilities
- Manage claim files effectively to conclusion
- Perform a three-point contact on all new losses within 24 hours
- Document ongoing case facts and relevant information accurately
- Maintain an up-to-date plan of action for assigned indemnity claims
- Collaborate with the medical case manager to maximize early return to work potential
- Initiate referrals for suspected fraud cases
- Pursue subrogation from culpable third parties
- Review and approve vocational rehabilitation plans
- Establish and monitor monetary case reserves
- Review medical bills for appropriateness
- Maintain a courteous and professional image for the company
- Respond to inquiries within specified timeframes
- Manage litigation process and handle additional duties as assigned
Requirements
- Bachelor's degree (B. A.) from four-year college or university
- At least seven years related experience and/or training
- Equivalent combination of education and experience
- Minimum of at least five years experience managing indemnity cases
- Claims handling expertise
- SIP certificate
- Working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims
Benefits
- Comprehensive medical, dental, and vision benefits
- Company contributions to HSA and FSA plans
- Employer paid life and disability insurance
- 401(k) with company match
- Paid time off (PTO) and company paid holidays
- Learning and development opportunities that support real career advancement
- Employee assistance resources and a supportive culture that values balance and wellbeing
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