"Alerted.org

Adecco is currently assisting one of its clients in their search for a Claims Adjuster to work remotely!

Pay rate: $45.00 per hour

Shift availability: Monday – Friday 8am – 4:30pm

Duration: 3+ month project

Primary Purpose:

To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

Responsibilities:

+ Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

+ Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

+ Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.Manages subrogation of claims and negotiates settlements.

+ Communicates claim action with claimant and client.

+ Ensures claim files are properly documented and claims coding is correct.

+ May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

+ Maintains professional client relationships.

Required Qualifications:

+ Mandatory: Workers Comp experience in Southeast state jurisdictions some or all AL. GA, FL, NC, SC, TNExperience: 5+ years of relevant WC experience with above mentioned states

+ Education – Bachelor’s degree from an accredited college or university preferred

+ Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business

+ Excellent oral and written communication, including presentation skills

+ PC literate, including Microsoft Office products

+ Analytical and interpretive skills

+ Strong organizational skill

+ Good interpersonal skills

+ Excellent negotiation skills

+ Ability to work in a team environment

+ Ability to meet or exceed Service Expectations

Work Environment:

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

As a reminder, this role is being recruited for by one of our National Recruitment Teams and not your local Branch. In order to be considered, please follow the steps included upon your application. If you are interested in the role, APPLY NOW for instant consideration!

**Pay Details:** $45.00 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

+ The California Fair Chance Act

+ Los Angeles City Fair Chance Ordinance

+ Los Angeles County Fair Chance Ordinance for Employers

+ San Francisco Fair Chance Ordinance