CCMS & Associates is in search of a Senior Workers’ Compensation Adjuster. This is a 1099 remote position.

We are seeking a licensed Texas adjuster with 5 years of experience, specializing in lost time workers’ compensation claims. Responsible for investigating and administering assigned Liability and/or Workers' Compensation claims and when warranted pursue litigation and subrogation against third parties. Alternative experiences in liability and casualty claims investigation and handling preferred.

Temporary position (to start) within a fast-growing independent adjusting and Third Party Administration firm with potential to convert to a team lead or supervisor upon assessment and performance evaluations.

Requirements:

• High School Diploma or GED

• Bachelor’s degree in related field (preferred); 5 or more years related experience; or equivalent combination of education and experience

• TEXAS All Lines Adjuster License with Continuing Education credits in workers compensation

• Working laptop computer, high-speed internet, Word, and Excel

• Must demonstrate strong time management skills

  Responsibilities:

• Effectively manage workers’ compensation files, including very complex claims

• Initiate and conduct investigation in a timely manner

• Determine compensability of claims and administer benefits, based on state law and in accordance with established company guidelines

• Manage medical treatment and medical billing, authorizing as appropriate

• Communicate with claimants, providers, and vendors regarding claim issues

• Compute and set reserves within company guidelines.

• Maintain diary system for case review and document the file to reflect status and work being performed

• Communicate appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns

• Conduct file reviews independently

• Direct and assist representatives attending hearings or mediations

• Adhere to all company policies and procedures

• Other duties as assigned

  Knowledge and Skills:

• Technical knowledge of statutory regulations and medical terminology

• In-depth assessment and analytical skills

• Excellent written and verbal communication, including the ability to convey technical details to claimants, clients, and staff

• Ability to interact with persons at all levels in a business environment

• Ability to independently and effectively manage very complex claims

• Proficient in Word and Excel

  All candidates must pass a full background check (void in states where prohibited)

Powered by JazzHR