Comp Medical Claims Adjuster Job Northern Kentucky USA,Insurance

Position: Work Comp Medical Only Claims Adjuster
Location: Northern

Summary:

Under moderate supervision and following standard procedures with some independent judgment, investigates, evaluates and resolves/disposes of general property, casualty and/or workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage, compensability, liability and damage in accordance with policy provisions by performing the following duties.

Adjuster License.
Experienced in GA.

Essential Duties and Responsibilities:

Follows corporate policies, procedures, and fair claims handling practices

Investigates claims to determine validity and extent of liability, including:

Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others
Reviews and evaluates documentation, including applications, reports, and statements

Monitors appropriate claim outcomes through self-audit process

Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues

Ensures legal, regulatory and fair claims handling compliance

Sets or recommends reserves based on results of claim investigation.

Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports.

May provide interaction with insureds, agents, claimants, attorneys, and other service providers, including:

Conducts in-depth interviews and/or scene inspections
Attends settlement conferences and/or trials

May serve as a member of project teams, contributing to the achievement of project objectives.

Performs other duties as assigned.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/

Experience:

Level 4:
Two to four years related experience and/or training; or associate's degree (A.A.) from two-year college/technical school; or equivalent combination of education and related experience/training.