Workers Compensation Claims Adjuster
Samsung Fire & Marine Insurance Co. - Ridgefield Park, NJ

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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.

Qualifications:

  • 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

Preferred:

  • 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)


Indeed - 16 months ago - save job
About this company
Established as Korea Anbo Fire and Marine Insurance Co., Ltd. on Jan. 26, 1952, we were renamed Samsung Fire & Marine Insurance Co.,...