Remote Workers Compensation Claims Adjuster (Oregon Jurisdiction) Job Vacancy in Professional Search Portland, OR – Latest Jobs in Portland, OR
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Company Name : Professional Search
Location : Portland, OR
Position : Remote Workers Compensation Claims Adjuster (Oregon Jurisdiction)
Job Description : 1. Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimant or injured workers, witnesses and producers.2. Analyzes coverage that may or may not be applicable to the claim by policy orstatutes. Reviews coverage issues as needed with supervisor and drafts positions as required.3. Establishes reserves based on estimating most likely outcome of a claim based on the facts for the case and company standard. Adjust reserves based on facts, company standard and experience.4. Occasionally claims adjusted by an Adjuster II will involve working with internal or assigned Legal Counsel. Build strong relationships, applying company principles and standards in partnership with internal legal counsel.5. Effectively negotiates non-litigated claims. Gains trust of other parties to negotiations and demonstrates good sense of timing.6. Depending on the type of claim may:a. Communicate with internal Managed Care and Medical resources to ensurecoordination with Medical providers on the development and authorization ofappropriate treatment plans as well as accurate billing.b. Obtain medical records and reports, police, ambulance and agency reports;photographs and measurements.7. Leverages and builds critical thinking and decision-making skills to gather, assess, analyze, question, verify, interpret and understand key or root issues.8. Writes in a clear, succinct and fact-based manner in Claims files as well as in other communication.9. Demonstrates ability to learn technical materials and learns from mistakes.10. Manages time and diary entries effective and efficiently, prioritizing work in a fast- paced environment.11. Establishes and maintains effective relationships with customers and gains their respect and trust.12. Performs other functional duties as requested or required.Unique Responsibilities:Completes basic compensability analysis based upon AOE/COE investigation.Verifies nature and extent of injuries.Able to identify change in claim exposure.Required:Bachelor’s degree or equivalent experience3+ years claims handling experienceState licensure as requiredDemonstrated proficiency with MS Office suitesDemonstrated skills in investigation, evaluation and negotiationStrong knowledge of insurance theory and practicesAbility to travel is required for some positionsJob Type: Full-timePay: $65,000.00 – $90,000.00 per yearBenefits:401(k)Dental insuranceHealth insurancePaid time offVision insuranceSchedule:Monday to FridayExperience:Workers’ compensation: 2 years (Required)License/Certification:Adjusters’ License (Required)Work Location: Multiple Locations
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