Claims Adjuster Senior, Worker’s Compensation Indemnity

CopperPoint Phoenix, AZ
Overview

As we continue our expansion plans into New Mexico, CopperPoint Mutual Insurance Company is offering an exciting opportunity for a Claims Adjuster Senior, Workers' Compensation Indemnity. In this role, the ideal candidate will be expected to analyze time loss workers' compensation claims to determine compensability. Adjudicate claims to ensure timely payment of indemnity and medical benefits due within company standards and in compliance with regulatory requirements. Establish and maintain action plans and reserves to ensure pro-active, cost effective claims management.

Responsibilities

As a Claims Adjuster Senior, Workers' Compensation Indemnity you will:

* Work with our agency partners as well as the underwriting team to highlight CopperPoint's exceptional customer service

* Primarily adjudicate New Mexico claims as well as other western states to potentially include Arizona and/or Utah

* Analyze and investigate indemnity claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers' compensation. Utilize all available resources as appropriate.

* Develop, maintain and adhere to action plans and reserves on indemnity claims while pro-actively managing claims to resolution. Establish and maintain cost drivers and data elements to ensure accurate NCCI and Medicare reporting.

* Pro-actively manage claims in accordance with company standards and statutory requirements. Ensure timely payment of indemnity and medical benefits.

* Actively utilize all available cost containment measures and programs i.e. evidence based medicine, subrogation, and vendors.

* Build and maintain professional relationships with injured workers, policyholders, brokers and agents through proactive claim management and timely communications.

* Identify settlement opportunities. Negotiate settlements with claimants and attorneys.

* Appropriately document communications and claim management activities.

* Conduct dispute resolution with claimants and attorneys. Testify at hearings when necessary.

Qualifications

We are seeking candidates with the following qualifications:

* BS/BA college degree preferred. The knowledge and skill levels acquired through undergraduate level studies especially in the areas of business administration, finance, management or marketing. Full time work experience in workers' compensation claim adjudication or related field, on a year for year basis will substitute for a degree.

* Minimum of 5 years of experience possessing strong technical claims knowledge with prior successful experience in a workers' compensation claims management environment.

* Analyze, interpret, and apply laws, rules and regulations pertaining to workers' compensation including knowledge of the specified jurisdiction's regulatory agencies and rate making entity, i.e. NCCI.

* State licensure if required by the jurisdiction for which this position is posted.

* Maybe required to be domiciled in the state.

* Strong analytical, organizational skills and critical thinking skills.

* Strong written and verbal communication skills.

* Ability to work in a team environment.

* Working knowledge of Microsoft Office Suites-Word, Excel

* Associates in Claims (AIC), Chartered Property & Casualty Underwriter (CPCU) certificates; or other professional designation preferred.

About CopperPoint Insurance Companies:

Rated A- "Excellent" by A.M. Best, is the state's premier provider of workers' compensation insurance

CopperPoint has begun to offer other additional commercial insurance products as well as offering worker's compensation insurance in other Western states

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