Senior Workers Compensation Claims Adjuster

Role Specifics:

• Jurisdiction: Arizona
• Licenses: Arizona license
• Location: This role is fully remote work (Must live in Phoenix Metro Area)
• Ability to visit Client on-site 1-2x a month in Peoria, AZ.
• Salary Range $89,000 to $97,000

We are currently seeking a dedicated and detail-oriented Senior Workers Comp Adjuster to join our Intercare team in Phoenix, AZ. We believe that every candidate brings something special to the table, including you! So, even if you feel that you’re close but not an exact match, we encourage you to apply.

If you are passionate about helping others, have a keen eye for detail, and thrive in a fast-paced environment, we want to hear from you! Join our team and make a difference in the lives of injured workers.

Summary:

Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor. In accordance with applicable statutes and in keeping with company rules, regulations, and established performance objectives, is responsible for effectively managing to conclusion an assigned inventory of claim files that may include cases of extreme complexity or with unique or unusual issues.

Essential Duties and Responsibilities:

• Perform a three-point contact on all new losses within 24 hours of receipt of the claim to include the claimant, employer, and treating physician to document relevant facts surrounding the incident itself as well as disability and treatment status.
• Thoroughly and accurately document ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and what is being done to move the case toward closure.
• Assure that all assigned indemnity claims have an up to date plan of action outlining activities and actions anticipated for ultimately resolving the claim.
• Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs.
• Initiate the referral to the SIU of cases with suspected fraud.
• Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability.
• Assure that the claim file is handled totally in accordance with applicable statutes as well as in-force service contracts and company guidelines.
• Review and approve all vocational rehabilitation plans.
• Establish, monitor, and adjust monetary case reserves when warranted and in strict accordance with assigned authority levels.
• Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file.
• Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company.
• Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt.
• Requires a working knowledge of the Labor Code of the State of California as it pertains to Workers Compensation Claims and the legal requirements for handling them.
• Litigation management - Direct, manage, and control the litigation process.
• Handles other duties and tasks as deemed appropriate by the Supervisor or Manager.

Competency:

To perform the job successfully, an individual should demonstrate the following competencies:

• Proven experience as a Workers Compensation Adjuster
• Knowledge of workers’ compensation laws and regulations in Arizona.
• Strong analytical skills.
• Excellent communication and negotiation abilities.
• Ability to work independently and as part of a team. Supports everyone’s efforts to succeed.
• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments.
• Interpersonal - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things

Qualification Requirements:

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:

High School Diploma or GED required. Bachelor's degree (B. A.) from an accredited college or university, preferred. Or equivalent combination of education and experience. Requires a high degree of indemnity claims handling expertise to include a minimum of at least five years’ experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues.

Benefits

• Competitive salary
• Flexible Schedule
• Health insurance benefits (Medical, Dental and Vision)
• Generous Paid Time Off
• 401(k)
• Referral incentive program
• Disability and Life Insurance
• Employee Assistance Program
• Additional Voluntary Benefits, e.g. Pet Insurance

As required by law, Intercare Insurance provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 89K-97K.

Intercare Insurance is an Equal Opportunity Employer.