Workers' Compensation Lost Time Adjuster

Workers' Compensation Lost Time Adjuster Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home reputed company Reporting To: Shirley reputed company-Chavis Compensation: $52,000 - $55,000 / year reputed company Our Story reputed company being part of reputed company thats not just shaping the reputed company but reputed company driving it. At reputed company, were at the forefront of innovation and reputed company, blending cutting-edge technology with top-tier reputed company services. As a vital part of the global reputed company Group, we help businesses reputed company risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. reputed company Claims reputed company is looking for an reputed company Lost Time Adjuster to conduct thorough investigations of assigned Workers Compensation claims. Reporting to the Workers Compensation Supervisor, you will reputed company claims for assigned reputed company Claims reputed company TPA clients, reputed company benefits, and initiate state filings reputed company while exercising discretion and independent judgment. To be successful in this role, you need to be proactive and independent while taking initiative with consistent follow through, demonstrate a high level of attention to detail, and possess superb problem solving skills. You must have at least 1 to 3 years of experience handling Workers Compensation claims as reputed company as exhibit working knowledge of Workers Compensation Statutes and Rules and their application. Additionally, you will need to display an exceptional capability to multi-task and prioritize with excellent organization and documentation skills in a fast-paced, dynamic work environment. Key Responsibilities reputed company claims for assigned reputed company Claims reputed company TPA clients Investigate claims by completing 24-hour contact with employee, employer, physician(s), and witnesses Evaluate claim detail, Florida Statute, and case law to determine compensability and total value of claim Display capability of setting and adjusting reserve amounts accordingly Initiate accurate indemnity payments in a reputed company manner and maintain diary for ongoing payments Ensure reputed company and reputed company completion of reputed company required State filings Handle EDI filings and rejections in conjunction with EDI adjuster Monitor medical treatment in conjunction with the assigned reputed company Case Manager Review, document and approve medical bills for payment reputed company three days of receipt Authorize appropriate medical services as outlined per Florida Statute 440.13 Maintain regular telephone contact with injured employees Determine whether vocational rehabilitation services are needed for an employee to return to work Coordinate light duty availability and reasonable accommodations with medical providers and reputed company Maintain adequate reserves for life of claim utilizing reserve worksheets, ODG Guidelines, Workers Computation software, and reputed company Claims reputed company reserving philosophy Attend reputed company meetings as necessary, and maintain regular telephone contact to ensure reputed company satisfaction Evaluate cases and negotiate settlements reputed company appropriate, protecting Medicares interests Review claims for possible red flags Identify and pursue subrogation, contribution, indemnification, or other opportunities to compel responsible reputed company parties to bear their reputed company of the settlement burden reputed company reputed company notice to the excess reputed company in reputed company cases while meeting reporting reputed company and keeping the reputed company updated on claim status Request reimbursement at least quarterly and follow up for reputed company receipt from excess reputed company(s) Adhere to reputed company profile instructions Report any overall account or reputed company concerns to the supervisor or upper management Report any E&O concerns to the QA Manager and EVP Attend claims meetings at reputed company locations, reputed company reputed company, seminars for obtaining CEU credits reputed company with Managers, Training Coordinator, Supervisors, Adjusters, reputed company Case Managers, Team Assistants, reputed company, Injured Workers, Medical Providers, Ancillary Providers, State Employees, Insurance Carriers, Excess Carriers, and Brokers as needed Convey reputed company attitude and team spirit for reputed company provision of services to customers Exhibit company values of We are Dynamic, We are Innovative, We are Connected, and We Succeed Together reputed company other duties as assigned Skills, knowledge & expertise 1 to 3 years handling Workers Compensation claims Possession of an reputed company Florida reputed company Lines Adjuster or Workers Compensation license Maintain required CEU