Workers' Compensation Claim Adjuster (NJ)

CCMSI is seeking a Workers' Compensation Claim Adjuster to investigate and adjust claims in accordance with established claim handling standards and laws. The ideal candidate will have 5+ years of claims experience and a bachelor's degree. The role is hybrid, with reporting to Linwood, NJ, and offers a competitive salary range of $65,000 - $70,000.

Requirements

• Investigate, evaluate, and adjust claims in accordance with established claim handling standards and laws
• Establish reserves and/or provide reserve recommendations within established reserve authority levels
• Review, approve, or provide oversight of medical, legal, damage estimates, and miscellaneous invoices to determine if reasonable and related to designated claims
• Negotiate any disputed bills or invoices for resolution
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority
• Negotiate settlements in accordance within Corporate Claim Standards, client-specific handling instructions, and state laws, when appropriate
• Assist in the selection, referral, and supervision of designated claim files sent to outside vendors (i.e., legal, surveillance, case management, etc.)
• Assess and monitor subrogation claims for resolution
• Review and maintain personal diary on claim system
• Client satisfaction
• Prepare reports detailing claim status, payments, and reserves, as requested
• Compute disability rates in accordance with state laws
• Effective and timely coordination of communication with clients, claimants, and appropriate parties throughout the claim adjustment process
• Prepare newsletter articles, as requested
• Provide notices of qualifying claims to excess/reinsurance carriers
• Handle more complex and involved claims than lower-level claim positions with minimum supervision
• Conduct claim reviews and/or training sessions for designated clients, as requested
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established

Benefits

• 4 weeks paid time off in the first year
• 10 paid holidays
• Medical
• Dental
• Vision
• Life Insurance
• Critical Illness
• Short and Long Term Disability
• 401K
• ESOP