Under limited supervision and with independent judgment, investigates, evaluates and resolves/disposes of workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage and compensability liability in accordance with policy provisions by performing the following duties.
Essential Duties and Responsibilities:
1. Follows corporate policies, procedures, and fair claims handling practices
2. Investigates claims to determine validity and extent of liability, including:
a. Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others
b. Reviews and evaluates documentation, including applications, reports, and statements
c. Monitors appropriate claim outcomes through self-audit process
d. Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues
e. Ensures legal, regulatory and fair claims handling compliance
3. Sets or recommends reserves based on results of claim investigation.
4. Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports.
5. May provide extensive interaction with insureds, agents, claimants, attorneys, and other service providers, including
a. Conducts in-depth interviews and/or scene inspections
b. Attends settlement conferences and/or trials
6. May serve as a member of project teams, contributing to the achievement of project objectives.
7. Provides leadership to junior staff by training and providing guidance. May provide input to management regarding junior staff performance.
8. Performs other duties as assigned.
Required Skills
5-7 years of handling workers' compensations claims in the states of TN, KY, and SC
Preferred licensed adjuster that can reciprocate license to other states
Required Experience
- Four to six years related experience and/or training; or bachelor's degree (B.A.) from four-year college/university; or equivalent combination of education and related experience/training.
- A minimum requirement for this position is the ability to work legally in the United States. No visa sponsorship/support is available for this position, including for any type of U.S. permanent residency (green card) process.
