Claims Adjuster

Chief of Staff KC is working with a local insurance company to find their next Medical Claims Adjuster! They are open to new grads and early-career individuals who are looking to join a fun office with a growing team.

Job Details:

• Performs initial review of claim and confirms appropriate tasks are set to push claim to closure
• Communicates significant information to employers such as when an injured worker has been referred to a specialist, reserves changes, and claim closure.
• Sets appropriate reserves; reviews and adjusts throughout the life of the claim as appropriate
• Reviews and processes bills in a timely manner
• Requests medical records and work statuses from provider
• Facilitates subrogation proceedings on claims involving third-party negligence in an effort to obtain maximum recovery
• Identify and discuss with supervisor when a claim has met criteria to be escalated to lost time
• Regularly reviews and updates claim status reports as facts of the claim change (i.e. reserve changes, significant medical updates, etc.)
• Timely response to incoming emails from employers and medical providers
• Works with lost time adjusters to coordinate specialist referrals