Workers' Comp Team Adjustor II - Intermountain Health
Lansing, MI
About the Job
Job Description:
The Workers Compensation Adjuster II manages workers compensation claims for the enterprise-wide self-insured/self-administered and multi-state workers compensation program. This position facilitates resolution of workers compensation claims by planning, organizing, executing, and managing the claims of employees of Intermountain and its affiliates, including modified duty programs, all aspects of indemnity claims, management of medical expenses only claims and litigated claims.
Position Details:
Incumbent will work Monday-Friday during regular business hours.
Essential Functions
+ Serves as a claims adjuster with working knowledge of the workers compensation laws in multiple states.
+ Manages relationships with third-party administrators (TPAs) for multi-state workers compensation claims to ensure quality service and cost effectiveness.
+ Investigates and evaluates workers compensation claims to determine compensability of individual claims and develops claim resolution strategy.
+ Collaborates with TPAs and legal counsel to manage specific cases and resolve issues.
+ Responsible for evaluating claims and setting appropriate reserves, authorizing medical treatment, prompt payment of medical and other bills and resolution of claims.
+ Assigns medical and vocational case managers as needed for high severity claims and work with these vendors to ensure positive and cost-effective outcomes.
+ Continually works to improve customer service by helping to set reasonable expectations for claimants, meeting and exceeding claimant expectations, responding to claimants, employee health, and other Intermountain departments as needed in a timely and professional manner.
+ Partners with Safety and Employee Health to identify injury trends and work on prevention and return-to-work plans.
+ Works collaboratively with injured workers to answer questions and address work-related needs.
+ Stays up to date on industry best practices, trends, innovations, and legislation related to workers' compensation.
Skills
+ Worker’s Compensation
+ Claims Management
+ Claims Best Practices
+ State Regulations
+ Data Analysis
+ TPA Oversight
+ Database Management
+ Risk Management
+ Claims Audits
+ Interpersonal Communication
Minimum Qualifications:
+ High School Diploma or GED required. Education is verified and must be obtained from an accredited institution.
+ Appropriate state adjuster’s license(s) must be obtained within three months of hire.
+ Demonstrates comprehensive knowledge of and/or ability to: (a) analyze federal, state and local laws, regulations, and guidelines regarding the administration of workers compensation claims; (b) develop and implement workers compensation claims management principles, practices, and procedures; and (c) interpret and understand medical, technical, and legal terminology used in workers compensation injury cases.
+ Demonstrates strong communication, collaboration, organization, and presentation skills.
+ Demonstrated collaborative, and results-oriented mindset, with the ability to work effectively in a fast-paced and dynamic environment.
+ Demonstrated experience completing projects that demonstrate a high degree of analytical thinking directed toward managing risk and problem solving
Preferred Qualifications:
+ Five years of relevant workers’ compensation adjusting experience, claims management, insurance, employee health or other relevant experience is preferred.
+ Associate's degree in risk management, Insurance, Public Health, Finance, Accounting, Business or related field preferred.
Physical Requirements:
Location:
Key Bank Tower
Work City:
Salt Lake City
Work State:
Utah
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$21.98 - $33.48
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
The Workers Compensation Adjuster II manages workers compensation claims for the enterprise-wide self-insured/self-administered and multi-state workers compensation program. This position facilitates resolution of workers compensation claims by planning, organizing, executing, and managing the claims of employees of Intermountain and its affiliates, including modified duty programs, all aspects of indemnity claims, management of medical expenses only claims and litigated claims.
Position Details:
Incumbent will work Monday-Friday during regular business hours.
Essential Functions
+ Serves as a claims adjuster with working knowledge of the workers compensation laws in multiple states.
+ Manages relationships with third-party administrators (TPAs) for multi-state workers compensation claims to ensure quality service and cost effectiveness.
+ Investigates and evaluates workers compensation claims to determine compensability of individual claims and develops claim resolution strategy.
+ Collaborates with TPAs and legal counsel to manage specific cases and resolve issues.
+ Responsible for evaluating claims and setting appropriate reserves, authorizing medical treatment, prompt payment of medical and other bills and resolution of claims.
+ Assigns medical and vocational case managers as needed for high severity claims and work with these vendors to ensure positive and cost-effective outcomes.
+ Continually works to improve customer service by helping to set reasonable expectations for claimants, meeting and exceeding claimant expectations, responding to claimants, employee health, and other Intermountain departments as needed in a timely and professional manner.
+ Partners with Safety and Employee Health to identify injury trends and work on prevention and return-to-work plans.
+ Works collaboratively with injured workers to answer questions and address work-related needs.
+ Stays up to date on industry best practices, trends, innovations, and legislation related to workers' compensation.
Skills
+ Worker’s Compensation
+ Claims Management
+ Claims Best Practices
+ State Regulations
+ Data Analysis
+ TPA Oversight
+ Database Management
+ Risk Management
+ Claims Audits
+ Interpersonal Communication
Minimum Qualifications:
+ High School Diploma or GED required. Education is verified and must be obtained from an accredited institution.
+ Appropriate state adjuster’s license(s) must be obtained within three months of hire.
+ Demonstrates comprehensive knowledge of and/or ability to: (a) analyze federal, state and local laws, regulations, and guidelines regarding the administration of workers compensation claims; (b) develop and implement workers compensation claims management principles, practices, and procedures; and (c) interpret and understand medical, technical, and legal terminology used in workers compensation injury cases.
+ Demonstrates strong communication, collaboration, organization, and presentation skills.
+ Demonstrated collaborative, and results-oriented mindset, with the ability to work effectively in a fast-paced and dynamic environment.
+ Demonstrated experience completing projects that demonstrate a high degree of analytical thinking directed toward managing risk and problem solving
Preferred Qualifications:
+ Five years of relevant workers’ compensation adjusting experience, claims management, insurance, employee health or other relevant experience is preferred.
+ Associate's degree in risk management, Insurance, Public Health, Finance, Accounting, Business or related field preferred.
Physical Requirements:
Location:
Key Bank Tower
Work City:
Salt Lake City
Work State:
Utah
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$21.98 - $33.48
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
Source : Intermountain Health
