Work Comp Medical Only Claims Adjuster

Summary: Under moderate supervision and following standard procedures with some independent judgment, investigates, evaluates and resolves/disposes of general property, casualty and/or workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage, compensability, liability and damage in accordance with policy provisions by performing the following duties.

• Adjuster License.
• Experienced in GA.

Essential Duties and Responsibilities:

• Follows corporate policies, procedures, and fair claims handling practices

• Investigates claims to determine validity and extent of liability, including:

• Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others

• Reviews and evaluates documentation, including applications, reports, and statements

• Monitors appropriate claim outcomes through self-audit process

• Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues

• Ensures legal, regulatory and fair claims handling compliance

• Sets or recommends reserves based on results of claim investigation.

• Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports.

• May provide interaction with insureds, agents, claimants, attorneys, and other service providers, including:

• Conducts in-depth interviews and/or scene inspections

• Attends settlement conferences and/or trials

• May serve as a member of project teams, contributing to the achievement of project objectives.

• Performs other duties as assigned.

Qualifications:

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/Experience:

Level 4: Two to four years related experience and/or training; or associates degree (A.A.) from two-year college/technical school; 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.