Workers Compensation Claims Adjuster

Position Summary
Investigate and settle advanced, large loss, complex claims promptly and equitably
under minimal supervision. Works within established authority on moderate-to-difficult
claims. Reviews coverages, determines liability and compensability, secures information,
arranges property damage appraisals and settles claims utilizing claims best practices.
Evaluates and sets reserves using independent judgment. Assists supervisor and
company attorneys in preparing cases for litigations. Conducts training and mentors
new hires.
Responsibilities
 Interprets and makes decisions using independent judgment on more complex
and unusual policy coverages and determines if coverages apply to claims
submitted.
 Manages all aspects of investigative activity on complex claims. Directs the
discovery and litigation strategy with legal counsel.
 Analyzes claims activity and prepares reports for clients/carriers and
management.
 Establish reserves, using independent judgment and expertise and authorizes
payments within scope of authority, settling claims in the most cost effective
manner and ensuring timely issuance of disbursements.
 Settles claims promptly and equitably and issues company drafts in payments for
claims within authority limits.
 Develops subrogation and third party recovery potential and follows reclaim
procedures.
 Analyzes claims activities and prepares reports for clients, carriers and/or
management. Participates in claim reviews.
Requirements
 Bachelor's degree or equivalent experience.
 Technical claims investigations/settling experience with 4-8 years experience in
Claims or similar organization.
 Workers Compensation (WC) Adjuster License required according to jurisdictional
requirements.
 Ability to work independently while assimilating various technical subjects.
 Strong written and oral communication, negotiation and presentation skills.
 Advanced analytical and problem solving skills, with the ability to manage and
prioritize multiple projects.
Preferred
 Industry designations such as IIA, AIC, AEI and/or CPCU

Eames Consulting is acting as an Employment Agency in relation to this vacancy.