Medical Only Work Comp Claims Adjuster

Job description

**This position can be remote** Summary: Under moderate supervision and following standard procedures with some independent judgment, investigates, evaluates and resolves/disposes of medical only 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. Essential Duties and Responsibilities: 1. Follows corporate policies, procedures, and fair claims handling practices 2. Investigates claims to determine validity and extent of liability, including: a. Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others b. Reviews and evaluates documentation, including applications, reports, and statements a. Monitors appropriate claim outcomes through self-audit process b. Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues e. Ensures legal, regulatory and fair claims handling compliance 3. Sets or recommends reserves based on results of claim inves...