Job: Workers' Comp Claims Adjuster

JOB OVERVIEW

Investigates, evaluates and resolves workers' compensation claims in order to minimize costs to Company member hospitals and clients.

RESPONSIBILITIES:

1. Investigates, evaluates, and resolves issues on assigned claims; establishes appropriate reserves pursuant to the departmental polices and procedures;avoids stair-stepping reserves

2. Contacts employers, injured workers, medical providers, and witnesses pursuant to the departmental polices and procedures; documents all communications in the diary notes. Visits scene of accident, if necessary; uses diagrams and/or photos where appropriate.

3. provides timely benefits in accordance with the workers' compensation statutes.

4. Negotiates settlements with injured workers and/or attorneys within limits of monetary authority as established by Claims Manager. Advises Claims Manager of settlement.

5. Based on developed facts, makes recommendations to Claims Manager and Employer.

6. Documents all activities on claims as they occur; maintain reference records and diaries.

7. Authorizes drafts for claims payments/bills.

8. Informs Loss Prevention Specialist of increased hazards or unusual circumstances concerning a risk.

9. Attends all mediation conferences (if possible). There may be scheduling conflicts

10. Maintains positive and frequent contact, including personal visits, with representatives of the programs clients.

12. Performs other duties as assigned by the WC Manager or Senior Adjuster.

SKILLS & REQUIREMENTS:

Must have thorough knowledge of NM workers’ compensation laws, five years’ adjusting experience, and experience with litigated files.

Strong written skills and computer proficiency required.

Some in-state travel.