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Workers Compensation Claims Adjuster (Breckpoint)

Company: Acrisure LLC
Location: Philadelphia
Posted on: May 16, 2022

Job Description:

Job DescriptionBreckpoint Risk Management Services of Pennsylvania, an Acrisure agency partner, has an exciting opportunity as a Workers' Compensation Claims Adjuster, The Claims Adjuster will investigate and analyze complex PA workers' compensation claims and determine approval or denial of benefits. The Adjuster will adjudicate the medical benefits of a claim, manage the file until all payments are completed. The Adjuster will regularly communicate with all parties associated with the claim including but not limited to injured employees, employers, and medical providers.Essential Duties and Responsibilities:

  • Promptly investigate assigned claims.
  • Determine coverage, and compensability.
  • Timely administration or denial of benefits within jurisdictional requirements and prepare necessary state filings.
  • Establish appropriate reserves on file to support claim's exposure and issue timely payments.
  • Proactive claim management including well documented action plans with goal to close claim as quickly and cost effectively as possible.
  • Negotiate settlements when appropriate with client approval.
  • Manage litigations and service vendors as needed.
  • Prepare professional claim write-ups in presentation ready format.
  • Use consistent clear and effective communication with all parties associated with the claim.
  • Maintain professional client relationships.This description is not meant to be all-inclusive and may be modified from time to time at the discretion of management.Competencies: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Education and/or Experience:
    • Must possess a high school diploma or the recognized equivalent.
    • College degree is preferred.
    • Must have a minimum of 5 years recent Pennsylvania Workers' Compensation claims adjuster experience overseeing and/or handling Pennsylvania Workers' Compensation claims.
    • Strong technical knowledge of Pennsylvania Workers' Compensation laws.Computer Skills:
      • Proficient in use of PC, including Microsoft Office productsOther Qualifications:
        • Strong knowledge of steps necessary to move files to conclusion
        • Ability to work both independently and in a team environment
        • Excellent oral and written communication skills and customer service experience
        • In-depth knowledge of workers' compensation cost containment principlesPhysical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
          • Moderate stress due to regular deadlines and daily challenges
          • High finger dexterity while typing documents and forms
          • Occasionally lift up to 20lbsWork Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job, and reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
            • Work is done in a temperature-controlled, non-smoking office
            • Work stations are cubicles with moderately high sides
            • The noise level in the work environment is usually moderateAcrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran or disability status. To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure's property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure's Human Resources Talent Department. Powered by JazzHRlraiB1bzdz

Keywords: Acrisure LLC, Philadelphia , Workers Compensation Claims Adjuster (Breckpoint), Other , Philadelphia, Pennsylvania

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