Skip to content

TPA Workers Compensation Claims Specialist

Apply now Share Share TPA Workers Compensation Claims Specialist with Facebook Share TPA Workers Compensation Claims Specialist with LinkedIn Share TPA Workers Compensation Claims Specialist with Twitter Share TPA Workers Compensation Claims Specialist with Google+ Share TPA Workers Compensation Claims Specialist with Viadeo Share TPA Workers Compensation Claims Specialist with a friend via e-mail

General Description: Adjuster of lost and non lost time claims for workers compensation.

Responsibilities:

  • Advanced Knowledge of claims function and processes.
  • Ability to effectively communicate with internal and external customers.
  • Strong understanding of workers compensation claims, strategies, resolution techniques and adjusting.
  • Technical capability to enter first reports of injury and to adjust lost time and non lost time claims utilizing the features of the TPA claim management systems.
  • Participates in claim advocacy and negotiations, including claim denials, reserving files, and claim reporting, issuing payments, attending hearings, conciliations or mediations and filing of state forms.
  • Determine compensability of the claim as it relates to the worker compensation jurisdiction.
  • Review and approval of loss time, medical services and expenses to be paid of the claims file.
  • Plan and attend claim reviews with clients, carriers and auditors.
  • Ability to identify client issues, build a plan towards resolution, execute and manage internal and external expectations effectively.
  • Analyzes claims based on the TPA best practices as outlined in the "Policy and Procedures" manual. 

Knowledge, Skills and Abilities:

  • Ideal candidate will have a minimum 5 years of workers compensation claims adjusting experience.
  • College degree preferred but high school diploma or graduate equivalent degree required.
  • Proficient-to-expert in MS Office suite of products.
  • Must be licensed in CT jurisdiction. 
  • Superior written and oral communication skills.
  • Ability to work well in a team environment.
  • Must have strong analytical thinking and problem-solving skills.
  • Strong organizational skills required.
  • Strong negotiation skills required.


#LI-DM2

#GLDR


Job ID:

17380

Interested in hearing about other USI Career Opportunities?

Join Our Talent Network
EEO is The Law - click here for more information
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
We endeavor to make this site accessible to any and all users. If you would like to contact us, please email recruiting@usi.com