Liability Claims Adjuster

Position: Claims Adjuster - Liability

Duration: 03 months of contract with possible extension or conversion

Pay Range: $31/hr to $33/hr on W2 without benefits.

Required:

• Someone who have supported retail environments.

Primary Purpose:

• To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements

Essential Functions and Responsibilities:

• Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
• Assesses liability and resolves claims within evaluation.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.
• ADDITIONAL FUNCTIONS and RESPONSIBILITIES
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Skills:

• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Excellent negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Service Expectations

Education & Licensing

• Bachelor's degree from an accredited college or university preferred.
• Experience: Four (4) years of claims management experience or equivalent combination of education and experience required.