Job description – WC/Liability Claim Adjuster
Career Field : WC(In-house Examiner)
Position : W.C. Analyst
Job Duration : Full Time
Office Location : New Jersey
Salary Offered : Open
Essential Job Function:
- Perform coverage review and determines all coverages applicable to the loss.
- Manage claim settlements in accordance with Company policy and practice. (the claims will not be handled in-house – the adjuster primary role will be to review the files and recommend cost effect solutions to reduce our payout)
- Supervise and managing litigation process via our TPA
- Effectively interact with and manage claims adjuster. Medical provider, vendors and outside counsel
- Assist in agency management by providing feedback to Underwriting and Loss Control.
- Monitor reserves set by our TPA to ensure same adequately reflects the exposures,
- Handle, manage, and oversee large loss cases with direct reporting to senior management.
- Provide superior customer service for all internal and external customers.
- Create claim strategies and processes.
- Establishing and create relevant claim guidelines and manuals.
- Developing and maintain productive relationships with medical management teams/vendors
- Assist in formalizing in-house medical management group.
- Excellent verbal and written communication skills.
- Strong CA worker’s compensation experience
- Superior knowledge of CA W.C. state laws and regulations
- Superior problem solving and negotiation skills.
- Skilled in technical claim practices.
- Board understanding of insurance market practices, issues, and trends, especially as they relate to claim trends and practices.
- Good computer skills and knowledge of all Microsoft applications
- Bachelor’s degree or equivalent work experience.
- Strong CA W.C. experience is preferred,:
- 5~9 years claim experience in WC of which minimum 4-5 years handling CA W.C. losses
- Exposure to multi-jurisdictional and multi-line claims, preferred.
- Must hold an adjusters license.
- Career designation preferred but not mandatory (AIC, CPCU, ARM or others)