MSIG North America continues to grow! Position Summary: This position is responsible for the adjudication of medical only workers’ compensation claims, assigned by our clientele, in accordance with the New Mexico Workers’ Compensation Statute, governing rules and regulations, related case law and client and company procedures. New loss assignments are client specific, based on case complexity. Essential Functions: Investigate the claim and verify information to determine cause of injury/accident history, determination of compensability. Interviewing employer, employees, witnesses; coordination of medical treatment and will learn skills necessary to take a recorded statement. Must possess the ability to maintain accurate and complete claim documentation in CMS and/or other client proprietary claim systems utilized. This position is responsible for reporting to clients per their specific guidelines. Must show proficiency in utilizing a diary system and keep open files maintained on that diary. Must have strong analytical skills for proper posting and monitoring of reserves for medical exposure pursuant to client instructions and/or company best practice standards. Timely review and payment of medical bills per Statutory requirements. Must be familiar with related case law and the ability to interpret and comply with client and company standards, policies, and procedures. Must make required State filings through EDI. Ensure that proper outside vendor referrals are made and properly justified. Knowledge of medical terminology to evaluate and interpret medical records/reports ensuring treatment is related to the reported injury. Identify strategies to close claim files timely or to transfer claims to a lost time adjuster for management of indemnity and more complex medical issues. Attend seminars, educational opportunities, and industry functions as a representative of the company. Job Qualifications: Education: High school diploma required. Bachelor’s degree from an accredited college or university preferred. Experience: This is an entry-level training position; however it is preferred that the applicant have some knowledge and recognition of a workers’ compensation claim. Prefer one to three years in the insurance industry or similar experience handling claims. Additional relevant experience considered in lieu of education. Required Skills/Abilities: Demonstrate ability to evaluate workers’ compensation medical claims required. Demonstrate beginning to intermediate knowledge of medical issues and injury occurrences. Possess superior customer service and conflict resolution skills. Strong presentation and negotiation skills. Attention to detail and accuracy. Excellent oral and written communication skills. Ability to build and maintain relationships with internal and external clients. Technologically savvy, able to navigate current computer system, proprietary client systems, and internet programs with speed and efficiency. Excellent organization skills including, ability to multi-task, prioritize, and maintain a diary / calendar system. Must be a self-starter with the ability to work independently and as part of a team. Specialized Knowledge, Licenses, etc.: Demonstrated proficiency in: Desire to pursue professional designations, such as AIC, ARM, CPCU (Preferred but not required) Ability to obtain Multiple Jurisdiction Adjuster Licenses (Required) MS Word and Outlook (Required) MS Excel and PowerPoint (Preferred) It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group! It is the policy of MSIG-NA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG-NA will provide reasonable accommodations for qualified individuals with disabilities. Each employee plays an important role which contributes directly to the success and continued growth of MSIG. MSIG Holdings (U.S.A.), Inc. (MSIG) is a wholly owned subsidiary of the MS & AD Insurance Group Holdings, Inc. – one of the top ten property-casualty insurance groups world-wide. Our Group has capital in excess of $25 Billion, operations in more than 40 countries and nearly 40,000 personnel located globally. MSIG in the U.S. is comprised of three insurance companies with licenses in all fifty states as well as Puerto Rico and the District of Columbia. These companies and five other subsidiaries, deliver state of the art risk financing programs, insurance products, risk engineering and claims management services that enable our clients to effectively and efficiently manage their risks. Our insurance companies share the A.M Best’s A XV Rating and Standard & Poor’s A Rating of our Japan-based parent. Our clientele runs the gamut from small and mid-sized, sole-proprietorships, partnerships and corporations, up to some of the largest and most sophisticated multinational corporations operating in the U.S. and globally. The vast majority of clients seek our support related to Commercial Lines insurance products including Commercial Property and Liability Insurance products. However, through our subsidiary – Seven Hills Insurance Agency, LLC. – we are able to provide Personal Lines Insurance products including homeowners, renters, automobile, etc. Specialties: All Risk Property, Commercial Liability, Automobile, Workers Compensation, Management Liability, Marine, Excess & Umbrella, Claims Management, Risk Engineering services, etc. Don't see the dream job you are looking for? Click "Get Started" below to drop off your contact information and resume and we will reach out to you if we find the perfect fit.