USI Insurance

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 or disability claims management, 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 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 all jurisdictions handled.
• 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.