Claims Adjuster | Workers' Compensation |

Title: Claims Adjuster | Workers' Compensation Location: REMOTE (current New Mexico residence) Innovative employee friendly Claims’ Third Party Administrator(TPA) has a brand new opening for a customer centric up and comer dedicated to New Mexico Claims handling MUST be NM residence. File counts are kept to a minimum with helpful Administrative staff and user friendly efficient software systems. Qualified Applicants MUST have recent New Mexico desk experience handling complex litigated Indemnity Claims handling experience and active Adjusters' License. Dedicated to New Mexico Files General Description Manage within company standards and best practices complex and problematic high visibility workers' compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim. Essential Job Duties Receives claim, confirms policy coverage & acknowledgement of claim Determine validity & compensability of claim by investigating & gathering info, file necessary documentation with state agencies Establish reserves & authorize payments within reserving authority limits Develop and manage well documented action plan with case manager, attorney, supervisor & client to reduce overall cost of claim Coordinating early return to work efforts with case manager & employer Negotiates settlements when necessary Actively manage the litigation process Identifies potential subrogation claims Communicate claim status with customer and claimant Adhere to client guidelines & participate in claim reviews as needed Develops & maintains professional customer relationships Education/Training Requirements Degree at an accredited college or university preferred Three years handling claims WC Lost Time Excellent oral, written communication skills & customer service PC literate, including Microsoft Office (Word, Excel) Effective analytical & interpretive skills Strong organizational skills Great interpersonal skills Skills: claims, workers compensation, adjuster: Recruiter Contact [email protected] Apply Job!