Claims Adjuster - Charleston, WV - UnitedHealth Group : Job Details

Review new Self-Insured claims on designated client accounts and determine compensability, establish reserves, review for subrogation, authorize medical treatment, establish a plan of action to achieve favorable claim resolution Handle all aspects of Self-Insured injury claims Recommend high level claim strategies to clients Refer claims to defense counsel and work with them regarding litigation management Attend and facilitate client meetings and claim reviews Review claims status and action plans using advanced problem resolution skills Provide status reports to clients Investigate, evaluate and negotiate resolution/settlement of some claims in accordance with state workers compensation laws Actively plans, prioritizes and tracks work status Assigns tasks to medical bill processors, payee specialists and others who work with the adjuster on claims Develops timeline and milestones This role requires the ability to adapt to changing needs of the programs they support, including the abi...Claims, Adjuster, Workers Compensation, Microsoft, Health, Insurance, Healthcare