Senior Workers' Compensation Claims Adjuster

Summary Statement

Provides quality investigation and analysis to adjust claims of medium complexity/severity, including litigated files, to proper resolution. Promotes the success of the organization through development of relationships with agencies, policyholders and employees.

Essential Tasks/Major Duties

• Collaborate and communicate with agents, policyholders and internal stakeholders on claims of medium complexity/severity and book of business.
• Investigate losses, identify coverage, determine compensability, review and analyze documents and legal pleadings.
• Develop plan of action to proactively conclude claims, timely evaluate damages, engage other parties in negotiations and settle claims pursuant to guidelines.
• Establish and maintain proper reserves for each claim to accurately reflect the financial exposure.
• Determine need for, identify and engage external resources as needed to execute proper resolutions while monitoring and controlling costs.
• Collaborate with counsel to manage litigated claims.
• Review and interpret commercial insurance policies and accordingly communicate coverage issues verbally and in writing.

Knowledge, Skills & Abilities

• Bachelor’s degree or equivalent combination of education.
• 3 years of experience handling workers’ compensation indemnity claims of medium level of complexity/severity.
• AIC or SLA certification preferred.
• Ability to obtain appropriate state licensing as required.
• Proficient computer skills required including Microsoft Office Suite.
• Demonstrated successful ability to build positive relationships and partnerships within department, across the organization and with external customers.
• Strong analytical skills and attention to detail.
• Excellent verbal and written communication skills with the ability to interact with internal and external customers.
• Ability to travel overnight up to 10%.
• Ability to travel daily between locations.