Sr. Adjuster-Workers Comp Claims

Founded in 1925, CopperPoint Insurance Companies is a leading provider of workers’ compensation and commercial insurance solutions across a ten-state footprint in the western United States.

About the role

The Workers’ Compensation Claims Adjuster Senior, Indemnity analyzes time-loss workers’ compensation claims to determine compensability, adjudicates claims to ensure timely payment of indemnity and medical benefits, and establishes action plans and reserves for proactive, cost-effective claims management.

Responsibilities

• Analyze and investigate indemnity claims to determine compensability by interpreting and applying workers’ compensation laws, rules, and regulations.
• Utilize all available resources to support claims decisions.
• 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 and negotiate settlements with claimants and attorneys.
• Conduct dispute resolution with claimants and attorneys.
• Testify at hearings when necessary.

Requirements

• At least 3 years of prior experience handling/adjusting workers’ compensation claims (this is not an entry-level position).
• 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.
• Strong technical workers’ compensation knowledge with prior successful experience in workers’ compensation and other commercial lines claims management.
• Knowledge of Department of Insurance (DOI), NCCI, and 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.
• Ability to set priorities, manage time, organize work, and meet deadlines.

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.
• Bilingual in Spanish is preferred.

Benefits

• Medical, dental, and vision insurance.
• Short-term disability, long-term disability, and life insurance (basic life and AD&D at two times annual salary provided at no cost).
• Health savings account (HSA) and flexible spending account (FSA).
• 401(k) plan with company matching contributions.
• 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, with corporate matching of personal charitable contributions up to $500 per year.
• Tuition reimbursement and other education benefits.
• Business casual dress code.

Pay

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