Sr. Adjuster-Workers Comp Claims

About the role

Come build with us. Backed by a 100-year legacy, CopperPoint is a specialty insurance company with deep expertise in Workers' Compensation and a growing Property and Casualty offering. Now we are expanding into the Southeast with a brand-new presence in Alpharetta, Georgia, and this is your chance to help shape it from the ground up. At our core is a simple belief that has guided us for a century: people taking care of people.

Responsibilities

• Analyze and investigate indemnity claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers' compensation. Utilize all available resources as appropriate.
• Build and maintain professional relationships with injured workers, policy holders, brokers and agents through proactive claim management and timely communications. Appropriately document communications and claim management activities.
• Develop, maintain and adhere to action plans and reserves on indemnity claims while proactively managing claims to resolution.
• Establish and maintain cost drivers and data elements to ensure accurate NCCI and Medicare reporting.
• Proactively manage claims in accordance with company standards and statutory requirements. Ensure timely payment of indemnity and medical benefits.
• Actively utilize all available cost containment measures and programs.
• Identify settlement opportunities. Negotiate settlements with claimants and attorneys. Conduct dispute resolution with claimants and attorneys. Testify at hearings when necessary.

Qualifications

• Bachelor's degree (B.S. or B.A.) in business administration, communications, or a related field from an accredited four-year college or university is preferred.
• This is not an entry-level position; all candidates must have at least three years of prior experience handling or adjusting workers' compensation claims.
• Must have prior WC claims handling experience. The ideal candidate will have WC claims handling experience in all our targeted states of FL, GA, NC, SC, and will also have expertise for other eastern jurisdictions.
• Excellent customer service skills, including initiative, mature judgment and discretion.
• Strong technical workers' compensation knowledge with prior successful experience in workers' compensation and other commercial lines claims management environments.
• Knowledge of Department of Insurance (DOI), NCCI, Department of Labor and Employment (CDLE) rules and regulations.
• Ability to analyze, interpret and apply laws, rules and regulations pertaining to workers' compensation.
• Ability to stay current with changes to statutory and industry rules and regulations, as well as company policies and procedures that may impact claims management.
• Ability to set priorities, manage time, organize work and meet deadlines.

Benefits

• Employees and their families are eligible to participate in CopperPoint Insurance Companies benefit plans including medical, dental, vision, short-term disability, long-term disability, life insurance, a health savings account, a flexible spending account, and a 401k plan.
• We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee's annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan).
• Employees will accrue 0.0769 hours of Paid Time Off (PTO) per paid hour, which may total 20 days a year. In addition, employees will also receive 10 paid holidays throughout the calendar year.