Workers' Compensation Claim Adjuster Job at Anne Arundel County, MD
Type of Position:
Contractual
Department:
Central Services
Closing Date:
Continuous Recruitment:
YES
Salary Range:
$25 - $30 per hour
Job Detail:
Type of Position:
Contractual
Department:
Risk Management, Central Services
Continuous Recruitment:
YES
Salary Range:
$25 - $30/hr
Job Detail:
This is a part time (1500 hours) workers’ compensation claims adjuster position with the Office of Risk Management. The primary role of this position is to investigate, negotiate, and settle claims filed against the Self-Insurance Fund.
Summary
Under minimal supervision, review, investigate, and process workers' compensation claims to successful resolution and closure.
Under minimal supervision, review, investigate, and process workers' compensation claims to successful resolution and closure.
Manage Claim Files
- Contact customers, medical providers, injured parties, attorneys and work sections to coordinate claims investigations, determine compensability, process treatment requests, initiate or respond to litigation, utilize surveillance, identify third party subrogation potential, and adjudicate claims in accordance with industry best practices.
- Plan, recommend, reserve, and execute file strategies on assigned claims in a manner consistent with best practices, corporate claim policies and procedures, and statutory, regulatory and ethics requirements.
- Recognize claim exposures and provide reports to management.
- Handle high volume of claims which includes initial file intake, project and execute accurate and timely payments, investigate mitigation opportunities on the file including subrogation, manage file to timely resolution, and complete all data integrity components.
- Manage claim deadlines. Develop and utilize jurisdictional expertise.
- Handle claim files in a manner consistent with Claim quality standards and goals.
Primary Job Duties & Responsibilities
Work with all parties on strategies for resolution of filed claims. Develop strategies to facilitate an injured employee's treatment and return to work and achieve maximum medical improvement. Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim. Coordinate with medical providers to ensure the injured employee is actively participating in a viable treatment plan. Evaluate medical treatment and engage independent medical examiners, peer reviews, or related services when appropriate. Work directly with work sections to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. Utilize Preferred Provider Network when applicable per jurisdictional guidelines. Respond to inquiries - oral and written. Process claims information diligently and pro-actively to facilitate successful resolutions of claims. Prepare files for hearing and/or trial. Review and calculate Commission awards as needed.
Work with all parties on strategies for resolution of filed claims. Develop strategies to facilitate an injured employee's treatment and return to work and achieve maximum medical improvement. Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim. Coordinate with medical providers to ensure the injured employee is actively participating in a viable treatment plan. Evaluate medical treatment and engage independent medical examiners, peer reviews, or related services when appropriate. Work directly with work sections to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. Utilize Preferred Provider Network when applicable per jurisdictional guidelines. Respond to inquiries - oral and written. Process claims information diligently and pro-actively to facilitate successful resolutions of claims. Prepare files for hearing and/or trial. Review and calculate Commission awards as needed.
Minimum Qualifications
High School Graduation (some college preferred)
High School Graduation (some college preferred)
Minimum 5 years of experience adjudicating lost time Workers Compensation Claims Management.
Experience with the handling of government, first responder and board of education claims is a plus.
Please email your resume to
rmlien99@aacounty.org
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