SENIOR WORKERS' COMPENSATION ADJUSTER - TEXAS - CCMS & Associates : Job Details

CCMS & Associates is in search of a Senior Workers Compensation Adjuster. This is a 1099 remote position.

We are seeking a licensed Texas adjuster with 5 years of experience, specializing in lost time workers compensation claims. Responsible for investigating and administering assigned Liability and/or Workers' Compensation claims and when warranted pursue litigation and subrogation against third parties. Alternative experiences in liability and casualty claims investigation and handling preferred.

Temporary position (to start) within a fast-growing independent adjusting and Third Party Administration firm with potential to convert to a team lead or supervisor upon assessment and performance evaluations.

Requirements:

+ High School Diploma or GED

+ Bachelors degree in related field (preferred); 5 or more years related experience; or equivalent combination of education and experience

+ TEXAS All Lines Adjuster License with Continuing Education credits in workers compensation

+ Working laptop computer, high-speed internet, Word, and Excel

+ Must demonstrate strong time management skills

Responsibilities:

+ Effectively manage workers compensation files, including very complex claims

+ Initiate and conduct investigation in a timely manner

+ Determine compensability of claims and administer benefits, based on state law and in accordance with established company guidelines

+ Manage medical treatment and medical billing, authorizing as appropriate

+ Communicate with claimants, providers, and vendors regarding claim issues

+ Compute and set reserves within company guidelines.

+ Maintain diary system for case review and document the file to reflect status and work being performed

+ Communicate appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns

+ Conduct file reviews independently

+ Direct and assist representatives attending hearings or mediations

+ Adhere to all company policies and procedures

+ Other duties as assigned

Knowledge and Skills:

+ Technical knowledge of statutory regulations and medical terminology

+ In-depth assessment and analytical skills

+ Excellent written and verbal communication, including the ability to convey technical details to claimants, clients, and staff

+ Ability to interact with persons at all levels in a business environment

+ Ability to independently and effectively manage very complex claims

+ Proficient in Word and Excel

All candidates must pass a full background check (void in states where prohibited)

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