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Claims Adjuster

Posted 15 days ago

  • Expiry Date: 11 February 2022

​​​​​​​​​Job Description:

  • PRIMARY PURPOSE:  To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
    ESSENTIAL FUNCTIONS and RESPONSIBILITIES
    Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
    Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
    Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
    Manages subrogation of claims and negotiates settlements.
    Communicates claim action with claimant and client.
    Ensures claim files are properly documented and claims coding is correct.
    May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
    Maintains professional client relationships.
    ADDITIONAL FUNCTIONS and RESPONSIBILITIES
    Performs other duties as assigned.
    Supports the organization's quality program(s).
    Travels as required.
    QUALIFICATIONS
    Education & Licensing
    Bachelor's degree from an accredited college or university preferred.
    Experience
    Four (4) years of claims management experience or equivalent combination of education and experience required.
    Skills & Knowledge
    Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
    Excellent oral and written communication, including presentation skills

About ASK:ASK Consulting is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Consulting connects people with amazing opportunities

ASK Consulting is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all associates.