What are the responsibilities and job description for the Workers' Compensation Claims Adjuster position at Hereford Insurance Company?
Maintain an open file case load (approximately 150); and a 1:1 closing ratio. Handle a case load of catastrophic aims, PPD and high-cost claims. Provide reserve and settlement authority ($30,000), Refer higher limit Files to the manager for authority. Resolve and settle cases with Workers' Compensation attorneys and HIC hearing reps; request appeals where applicable. Assign cases for ME, Investigations and Case Management. Negotiate and settle outstanding medical bills. Settle cases through Section 32 and SLU process. Complete 3-point contact (claimant, insured and provider) within 48 hours. Timely filing of WCB forms to avoid penalties, Timely processing of Workers' Compensation Board awards. Review medical bills for payment and causal relationship. Issue timely payments (bi-weekly) including CCP Indemnity and awards, Maintain a daily diary of pending. Follow-up with subrogation (loss transfer and 3rd party claims).
Qualifications: At least 5 years proven, current experience as a NY workers' compensation claims examiner/adjuster: detailed working knowledge of the additions to the medical treatment guidelines effective 2014.
Salary : $60,000 - $70,000
