• Lost Time Adjuster

    Job Locations US-PA-Blue Bell
    # of Openings
    5
    Category
    Worker's Compensation
  • Overview

     

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    Position Title: Lost Time Adjuster

     

    Position Location:  Philadelphia, PA

     

    Position Summary:

    • Our Contractor is seeking several Worker’s Compensation Loss Time Adjusters. As a member of the claims team, you will use your knowledge and experience to independently investigate, evaluate and resolve assigned claims of a more complex nature to achieve appropriate outcomes. In this position, you will administer and settle highest risk management expectations claims promptly by legal status, policy provisions, and company guidelines.

    Duties and Responsibilities:

    • Promptly investigates all assigned claims with minimal supervision, including those of a more complex nature.
    • Determines coverage, compensability, and potential for subrogation recovery.
    • Position ensures the timely denial or payment of benefits in accordance with jurisdictional requirements.
    • Within granted authority, establishes appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure.
    • Negotiates claims settlements within granted authority.
    • Establishes and implements appropriate action plans for case resolution including medical and disability management, litigation management, negotiation, and disposition.
    • Works collaboratively with nurse professionals to develop and execute a return to work strategies.
    • Selects and manages service vendors to achieve an appropriate balance between allocated expense and loss outcome.
    • Maintains a working knowledge of jurisdictional requirements and applicable case law.
    • Demonstrates technical proficiency through timely, consistent execution of best claim practices
    • Communicates effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues.
    • Provides a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings, and similar account- specific sessions.
    • Authorizes treatment based on the practiced protocols established by statute or the Managed Care department.

    Compensation:

    • 45k to 65k.  Full benefits package.  Long-term position.

    Qualifications Required:

    • Associate in Claims (AIC) Designation or similar professional designation desired.

    Education/Experience:

    • Bachelor's degree and/or four or more years of equivalent work experience required in an insurance related industry required.

    Preferred Skills/Qualifications:

    • Associate in Claims (AIC) Designation or similar professional designation desired.
    • Should have some familiarity with medical terminology and/or Workers' Compensation.
    • Certifications and/or licenses as required by State regulation. 
    • Familiarity with medical terminology and/or Workers' Compensation.

    To Apply:

    • Please submit an online application at ACSC1.com, or send a resume directly to mmcmahon@ascs1@gmail.com.

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