Sr. Workers Compensation Claims Adjuster

About Acrisure:

Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters, including Insurance, Reinsurance, Cyber Services, Mortgage Origination and more.

Acrisure employs over 17,000 entrepreneurial colleagues in 21 countries and have grown from $38 million to $4.3 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win.

Job Summary:

The Workers’ Compensation Claims Adjuster must be knowledgeable of  California laws and administration of claims. 

It is the responsibility of a Workers' Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination regarding the claim. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims.  Workers' Compensation Claims Adjusters abide by company guidelines when making claim determinations.

This role requires excellent communication and customer service skills, strong motivation and organizational skills.

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Responsibilities:

• Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution.

• Complete quality investigations by gathering pertinent information.  Reviews and evaluates coverage and/or liability.  Secures necessary information (i.e., reports, policies, releases, statements, or other documents) in the investigation of claims.

• Conduct a thorough analysis of liability and continually assess exposure and evaluate for accurate reserves.

• Works toward the resolution of claims files and takes full charge of claim from inception to resolution.

• Will affect settlements/reserves within prescribed limits and submits recommendations to supervisor on cases exceeding personal authority.

• Ensures that claims payments calculated accurately and are issued in a timely and accurate manner. 

• Ensures compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements. 

• Maintains a diary to follow claim progress on all claims.

• Determine liability for permanent disability, mitigation of costs and resolution of claim.

• Oversee litigation and coordination of claim with defense team.

Qualifications:

• 5 years plus experience handling workers’ compensation claims.

• Current California Adjuster Certification.

• Familiarity with state workers’ compensation laws and regulations

• Candidates will be required to have strong skills in customer service, verbal and written communications, time management, and organizational skills. 

• Excellent attention to detail.

• Must demonstrate an ability to work independently.

• Must demonstrate a strong knowledge of computers and software.

Communication Skills:

• Demonstrated ability to manage relationships in a fast-paced environment along with problem solving and decision-making skills to work through a variety of challenging situations.

• Ability to respond to requests effectively and efficiently.

• Listens effectively and clearly expresses ideas and recommendations.

• Proficient in communicating effectively and clearly, both orally and in writing.

• Capable of carrying out detailed written or verbal instructions.

Technical Expertise:

• Complete understanding of all Microsoft Office applications.

• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.   

• Proficient in the operation of computer equipment and applications.

Customer Service:

• Responds timely and consistently with all communication.

• Builds credibility with internal and external customer.

• Creates customer satisfaction.

• Familiar with the company tools and is comfortable reviewing with all levels of management in a professional manner.

Work Environment/Hours

• This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machine