Workers Compensation Senior Adjuster

Job Purpose or Objective: This role is responsible for analyzing claim data, setting financial reserves, approving payments, and coordinating with medical providers, legal representatives, and internal departments. Additionally, the Senior Adjuster plays a key role in case management, benefit calculations, and continuous process improvement to ensure effective and compliant claims administration. You will report to the Workers Compensation Manager.

Monday-Friday, 8:00am-4:30pm

• You will assist Manager on budget planning and reporting to department leadership.
• Oversee complex claims and provide expert guidance to adjusters in the resolution and handling of these cases.
• Analyze claim data-including employer reports, medical documentation, and associate interviews-to determine compensability.
• Review documentation to set appropriate reserves, determine reimbursement amounts for providers and team members, and calculate benefits such as injury leave and mileage for submission to accounting.
• You will testify in litigation matters within the Choctaw Nation court system.
• Review the Workers' Compensation fee schedule, approve medical provider payments and third-party invoices, and coordinate reimbursement processing.
• You will assign complex claims to case managers and ensure timely updates and ongoing case oversight.
• Serve as the liaison between CNOSH and Workers'' Compensation to ensure accurate and timely OSHA reporting and recordkeeping compliance.
• Coordinate internal case management activities involving CNHSA, CNOSH, and external medical providers to ensure comprehensive care and compliance.
• Perform all other duties as may be assigned.

MINIMUM

• Bachelors' degree in General Studies or equivalent combination of education and experience
• Workers' Compensation Adjuster License and/or ability to attain License within 90 days of hire
• Ability to determine compensability and the need for subrogation
• Excellent communication skills
• Knowledge of Workers' Compensation Systems
• Knowledge of statutes to analyze situations accurately
• Knowledge of Medical Terminology
• Knowledge of Occupational Safety & Health recordkeeping requirements
• Five (5) years' experience adjusting claims and reserving claims
• Bilingual proficiency preferred

About the Choctaw Nation

The Choctaw Nation is the third-largest Indian nation in the United States, with over 200,000 tribal members and more than 11,000 employees. The first tribe over the Trail of Tears, historic boundaries are in the southeast corner of Oklahoma. The Choctaw Nation''s vision, "Living out the Chahta Spirit of faith, family and culture," is evident as it continues to focus on providing opportunities for growth and prosperity.

Benefits

• Free gym membership
• Free access to employee health clinic
• Free lunch for casino & resort associates
• Earned wages access once per week for hourly Associates
• Pet insurance
• Paid vacation / sick time
• Medical / Dental / Vision
• 401(K) with company match
• College tuition reimbursement
• Short-term disability, long-term disability, and family leave
• Employee assistance program
• Employee prescription program
• CNO Paid Life Insurance
• Teladoc
• On Site Dental Clinics (Jet Dental)
• On Site Mammogram Services
• Free diabetes and hypertension monitoring benefit (Livongo)
• Accolade- Concierge Benefits Program
• Wellness Program that equals savings on health insurance cost (Virgin Pulse)
• Maternity Care Program
• (Benefits provided by the Choctaw Nation are based on employment classification)

CNO was selected as a winner in both HRDUS'' and Forbes'' 2022 "Employer of Choice" competitions:

• Choctaw Nation of Oklahoma received recognition as one of six Best Places to Work in the United States as selected by HRDUS
• Choctaw Casinos & Resorts received recognition from Forbes as a Best Employer for Diversity in the Travel & Leisure category.
• Forbes also recognized the Choctaw Casino and Resorts as one of America''s Best Employers for New Graduates.

#LI-onsite

• Bachelors' degree in General Studies or equivalent combination of education and experience
• Workers' Compensation Adjuster License and/or ability to attain License within 90 days of hire
• Ability to determine compensability and the need for subrogation
• Excellent communication skills
• Knowledge of Workers' Compensation Systems
• Knowledge of statutes to analyze situations accurately
• Knowledge of Medical Terminology
• Knowledge of Occupational Safety & Health recordkeeping requirements
• Five (5) years' experience adjusting claims and reserving claims
• Bachelors' degree in General Studies or equivalent combination of education and experience
• Workers' Compensation Adjuster License and/or ability to attain License within 90 days of hire
• Ability to determine compensability and the need for subrogation
• Excellent communication skills
• Knowledge of Workers' Compensation Systems
• Knowledge of statutes to analyze situations accurately
• Knowledge of Medical Terminology
• Knowledge of Occupational Safety & Health recordkeeping requirements
• Five (5) years' experience adjusting claims and reserving claims