Workers Compensation Claims Adjuster

Risk Strategies Company Kansas City , MO 64138

Posted 3 weeks ago

Job Summary

Risk Strategies is a top national specialty insurance brokerage and risk management firm assisting organizations and individuals to simplify the process of protecting assets, offering benefits and minimizing liability. With over 100 offices and 3,300 employees across the US & Canada, we thrive on our passion to be ranked a Best Places to Work since 2018 by our most important asset, our employees. For 2020, Risk Strategies was named 6th Fastest Growing Firm, 12th Largest Personal Lines Broker, 11th largest privately-held P&C Broker and the 16th largest US Broker by Insurance Journal.

The Claim Adjuster provides various functions in the management of claims administered by the Risk Management department:

Primary Responsibilities and Duties:

  • Serves as a dedicated resource to Risk Management customers for handling and communication of workers compensation and/or property and casualty claims
  • Serves as a designated Adjuster as part of the service team for specific accounts
  • Makes contacts, investigates questionable losses, documents facts surrounding the incident, to include decision regarding liability/compensability, as well as action plan and reserve rationale
  • Explains benefits, close contact with injured workers to prevent litigation
  • Uses outside vendors to determine damages or mitigate exposures, use of vendors who assist with coordination of medical treatment and return to work, and use of defense counsel on litigated claims may be necessary
  • Identifies and pursues fraudulent claims
  • Investigates potential subrogation and pursues third-party continuing through the recovery process
  • Works directly with Claim Technician to assure mail is addressed, bills are paid and customers questions are answered quickly and appropriately
  • Uses strong diary system to ensure timely follow up and monitors treatment, receipt of bills or records, reserve adequacy, negotiation of settlement, payment and closure
  • Uses cost containment strategies in daily activities to include direction to PPO networks, close monitoring of investigators and aggressive litigation management
  • Maintains a strong back-up process with the other Adjuster on the team, and with the Claim Technician to assure consistent service during absences of any member of the team
  • Makes sure the team is functioning at a high level at all times, to include providing feedback on performance of Claim Technician to the Manager, Risk Management Claims
  • Mentors the Claim Technician in educating them regarding Adjuster position responsibilities to promote growth and advancement
  • Requirements and Qualifications:

  • Bachelors degree from an accredited four-year college or university, or equivalent experience
  • Strong organizational skills
  • Ability to apply mathematical concepts
  • Ability to work successfully in a deadline driven environment
  • Ability to attend social functions for clients and carriers in order to build relationships
  • Working knowledge of Microsoft products (Word, Excel, Outlook, etc.)
  • Working knowledge and comfort level with claims management systems; and comfort working in a paperless environment
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    Workers Compensation Claims Adjuster

    Risk Strategies Company