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Work Comp Claims Adjuster

Remote · South Africa Full-time

Looking for someone with wage loss experience in the states of IL/MI/IN

This position has the ability to work remotely Summary: Under general supervision and following standard procedures with independent judgment, investigates, evaluates and resolves/disposes of workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage, compensability, and liability in accordance with policy provisions by performing the following duties. Essential Duties and Responsibilities: Follows corporate policies, procedures, and fair claims handling practices Investigates claims to determine validity and extent of liability, including: Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others Reviews and evaluates documentation, including applications, reports, and statements Monitors appropriate claim outcomes through self-audit process Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues Ensures legal, regulatory and fair claims handling compliance Sets or recommends reserves based on results of claim investigation. Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports. May provide extensive interaction with insureds, agents, claimants, attorneys, and other service providers, including: Conducts in-depth interviews and/or scene inspections Attends settlement conferences and/or trials May serve as a member of project teams, contributing to the achievement of project objectives. Performs other duties as assigned. Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience: Level 4: Two to four years related experience and/or training; or associate's degree (A.A.) from two-year college/technical school; or equivalent combination of education and related experience/training.

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