Job Location : all cities,TX, USA
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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