Workers Compensation Claims Adjuster III managing complex claims at AvonRisk. Reports to Claims Supervisor and oversees assigned inventory with a focus on professional growth and support.
Responsibilities
Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup
Manage an assigned inventory of claim files that may include complex cases
Perform a three-point contact on all new losses
Document ongoing case facts and necessary information
Ensure all assigned indemnity claims have an up to date plan of action
Form partnership with the medical case manager
Initiate the referral to the SIU of cases with suspected fraud
Pursue subrogation from culpable third parties
Review and approve all vocational rehabilitation plans
Establish, monitor, and adjust monetary case reserves
Review all medical bills for appropriateness
Maintain a courteous and professional image and respond to inquiries in a timely manner
Requirements
Bachelor's degree (B. A.) or equivalent
Minimum seven (7) years related experience
Equivalent combination of education and experience
High degree of claims handling expertise
Minimum of at least five years experience managing indemnity cases
SIP certificate
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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