Sr. Workers Compensation Claims Adjuster (CO Jurisdiction

Salary: $80,000 to $90,000 (depending on experience)

Type:
Hybrid

DUTIES AND RESPONSIBILITIES:

• Effectively manages an active caseload of 150 workers’ compensation files, including medical only, indemnity, lifetime medical and permanent partial benefit claims.*
• Initiates and conducts claims investigation in a timely manner.*
• Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.*
• Manages medical treatment and medical billing, authorizing as appropriate.*
• Communicates with claimants, providers and vendors regarding claims issues.*
• Computes and set reserves within Company guidelines.
• Maintains diary system for case review and document file to reflect the status and work being performed on the file.*
• Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.*
• Adheres to all Company policies and procedures.*
• Participates in file reviews with clients, as needed.
• Other duties as assigned and including claims management of other jurisdictional workers’ comp claims.

* Essential job function.

EQUIPMENT OPERATED/USED: Computer, 10-key, fax machine, copier, printer and other office equipment.

SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire.

QUALIFICATIONS REQUIRED:

Education/

Experience:

High School Diploma or GED required;
Bachelor’s degree in related field (preferred); and two (2) years related experience (preferred); or equivalent combination of education and experience.

Knowledge, Skills and Abilities:

• Analytical skills.
• Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
• Ability to interact with persons at all levels in the business environment.
• Proficient in Word and Excel (preferred).