Sr. Adjuster-Workers Comp Claims

CopperPoint has an exciting opportunity for a fully remote Workers’ Compensation Claims Adjuster Senior, Indemnity. The ideal candidate must possess Arizona jurisdiction technical claims knowledge. Additional experience in MO, KS, CO, UT, NM, NV, and/or TX jurisdictions is preferred.

About the role

The Workers’ Compensation Claims Adjuster Senior, Indemnity is responsible for analyzing time loss workers’ compensation claims to determine compensability. They will adjudicate claims to ensure timely payment of indemnity and medical benefits within company standards and in compliance with regulatory requirements, as well as establish and maintain action plans and reserves to ensure proactive, cost-effective claims management.

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.

Requirements

• 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.
• At least 3 years of prior experience handling/adjusting workers’ compensation claims.
• Arizona workers’ compensation claims management experience is required.
• Experience/licensure in one or more of the following states is highly preferred: MO, CO, UT, KS, NM, NV, OK, and/or TX.
• Excellent customer service skills, including initiative, mature judgment, and discretion.
• Bilingual in Spanish preferred.
• Strong technical workers’ compensation knowledge with prior successful experience in workers' compensation as well as 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, industry rules, and regulations as well as company policies and procedures which may impact claims management.
• Ability to set priorities, manage time, organize work, and meet deadlines.

Benefits

• Medical, dental, and vision insurance.
• Short-term disability, long-term disability, and life insurance.
• Health savings account (HSA) and flexible spending account (FSA).
• 401k plan with company matching contributions.
• Basic Life Insurance and AD&D at two times the employee’s annual salary at no cost to the employee.
• Employee Assistance Plan (EAP).
• Paid Time Off (PTO) accrual of 0.0769 hours per paid hour (up to 20 days per year).
• 10 paid holidays throughout the calendar year.
• 12 hours of paid volunteer time annually.
• Corporate matching for personal charitable contributions up to $500 per year.
• Tuition reimbursement and other education benefits.

Pay

Salary range: $68,000.00 - $98,500.00 annually. Compensation may vary depending on skills, experience, education, and geographical location. In addition to base salary, compensation may include an annual discretionary bonus.