Senior Lost Time Claims Adjuster

3 weeks ago

Minneapolis, United States PMA Companies Full time

As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines. The preferred candidate for this role can work remote, but must have assigned risk experience, and will handle both Iowa and Minnesota jurisdictions.

Responsibilities:

  • Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature
  • Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)
  • Alert Supervisor and Special Investigations Unit to potentially suspect claims
  • Ensure timely denial or payment of benefits in accordance with jurisdictional requirements
  • Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure
  • Negotiate claims settlements with client approval
  • Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition
  • Work collaboratively with PMA nurse professionals to develop and execute return to work strategies
  • Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome
  • Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced
  • Demonstrate technical proficiency through timely, consistent execution of best claim practices
  • Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues
  • Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions
  • Authorize treatment based on the practiced protocols established by statute or the PMA Managed Care department
  • Assist PMA clients by suggesting panel provider information in accordance with applicable state statutes.
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

  • Bachelor's degree, or four or more years of equivalent work experience required in an insurance related industry required
  • Experience with Assigned Risk is required
  • At least 3-5 years' experience handling lost time workers compensation claims required; past experience with Iowa and Minnesota jurisdictions is required
  • Associate in Claims (AIC) Designation or similar professional designation desired.
  • Active license required or ability to obtain license within 90 days of employment in mandated states.
  • Familiarity with medical terminology and/or Workers' Compensation
  • Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
  • Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
  • Strong verbal, written communication skills and customer service skills
  • Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
  • Ability to travel for business purposes, approximately less than 10%.

  • Claims Adjuster

    4 weeks ago

    Minneapolis, Minnesota, United States Insurance Placement Solutions Full time

    Insurance Placement Solutions has an immediate opening for a Remote Workers Compensation Claims Adjuster with our client. As a member of our client's claims team, utilize your knowledge of workers' compensation to independently investigate, evaluate and resolve assigned claims in order to achieve appropriate outcomes. In this position, you will administer...

  • Senior Lost Time Claims Adjuster

    3 weeks ago

    Minneapolis, United States PMA Companies Full time

    As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues,...

  • Claims Adjuster

    3 weeks ago

    Minneapolis, United States American Farm Bureau Insurance Services, Inc. Full time

    TITLE: Claims Adjuster DEPARTMENT: Claims LOCATION: This position is remote, but the candidate must be willing to travel in and through Minnesota. POSITION OBJECTIVE: Perform loss adjustment, pre-acceptance and quality control activities for Crop Hail and Federally Reinsured Crop Insurance products in accordance with established procedures. Works...

  • Senior Workers' Compensation Claims Consultant | Remote

    3 days ago

    Minneapolis, United States KING'S INSURANCE STAFFING LLC Full time

    Our client, an A-rated Insurance Carrier, is seeking to add a strong Senior Workers' Compensation Claims Consultant with strong knowledge in Minnesota Law. This would be a fully remote position. Duties will consist of handling mid to complex Minnesota Workers' Compensation Lost Time claims from inception to close. Qualified candidates must possess a strong...

  • Claims Field Adjuster

    1 week ago

    Minneapolis, United States Munich Re Full time

    **Claims Field Adjuster - Minneapolis MN Remote** ** WE OFFER** If you're looking for a rewarding career in a growing company with a true career path, it's time to claim your future with the American Modern claims department. You'll be working on the frontlines of our business, supporting customers in times of need and disaster. American Modern invests...

  • Commercial Auto Claims Field Adjuster

    1 week ago

    Minneapolis, United States Great West Casualty Company Full time

    Take your tractor trailer and estimating skills out of the shop and into the field with a career as a Commercial Auto Claims Field Adjuster. This position is fully remote and will be located in or around the Minneapolis-St. Paul, MN area. As a Commercial Auto Claims Field Adjuster for Great West, you will investigate, negotiate, and settle claims in the...

  • Claims Consultant, PC

    3 weeks ago

    Minneapolis, United States Holmes Murphy & Associates Full time

    About Us: Have you thought how rewarding it would be to use your knowledge and experience to help clients improve their claim process and outcomes? Do you enjoy helping clients and solving problems? If that sounds like you, consider joining our team! Holmes Murphy is one of the nation's largest privately held insurance brokerages. It is our mission to...

  • Claims Processor

    7 days ago

    Minneapolis, United States Adecco Medical & Science Full time

    Adecco is currently assisting a great client in their search to fill a Claims Processor position.Type: 40hrs/wk. ContractStart Date: Within two to three weeks.Location: Flexible; Not in Office. Must sit in EST or CST time zones. Pay: $20.00 to $ 20.00/hr Length: Long TermHours: 8am to 5pm EST; Monday thru FridayResponsibilities for the Claims Processor role...

  • Claims Specialist, PC

    3 weeks ago

    Minneapolis, United States Holmes Murphy & Associates Full time

    Have you thought how rewarding it would be to use your knowledge and experience to help clients improve their claim process and outcomes? Do you enjoy helping clients and solving problems? If that sounds like you, consider joining our team! Holmes Murphy is one of the nation's largest privately held insurance brokerages. It is our mission to promote health,...

  • Client Specialist in Workers Compensation

    3 days ago

    Minneapolis, United States DGA Careers Full time

    Job description We are searching for a Client Specialist in Workers Compensation to work remotely for a major insurer. This role is completely remote, and you'll be provided with the necessary tools (laptop, internet coverage, etc.) in order to do a stellar job. Requirements: Experience handling claims in NE, and MN jurisdictions Although remote, you must...

  • Client Specialist in Workers Compensation

    4 weeks ago

    Minneapolis, United States DGA Careers Full time

    Job descriptionWe are searching for a Client Specialist in Workers Compensation to work remotely for a major insurer. This role is completely remote, and you'll be provided with the necessary tools (laptop, internet coverage, etc.) in order to do a stellar job.Requirements:Experience handling claims in NE, and MN jurisdictionsAlthough remote, you must reside...

  • Senior Resolution Specialist

    4 weeks ago

    Minneapolis, Minnesota, United States Gallagher Full time

    About Us: Join our growing team of dedicated professionals at Gallagher Bassett, who guide those in need to the best possible outcomes for their health and wellbeing. You'll be part of a resilient team that works together to redefine the boundaries of excellence. At our organization, we value collaboration and making a positive impact in the lives of our...

  • WEEKEND COOK

    3 weeks ago

    Minneapolis, United States Suite Living Senior Care Full time

    Job DescriptionJob DescriptionPOSITION: WEEKEND COOKCOMPANY: Suite Living Senior CareLOCATION: Crystal, MNTYPE: Part Time (E/O Wknd OR Every Weekend!)SHIFT: 9:30am-5:30pm, Saturday & SundayPAY RANGE: $16-20/hour (DOE, Negotiable)SUMMARY:Suite Living Senior Care is seeking a WEEKEND Cook to join our team!You can choose to work EVERY weekend, or EVERY OTHER...

  • WEEKEND COOK Senior Living Community

    3 weeks ago

    Minneapolis, United States Suite Living Senior Care Full time

    POSITION: WEEKEND COOKCOMPANY: Suite Living Senior Care LOCATION: Crystal, MN TYPE: Part Time (E/O Wknd OR Every Weekend!) SHIFT: 9:30am-5:30pm, Saturday & Sunday PAY RANGE: $16-20/hour (DOE, Negotiable) SUMMARY: Suite Living Senior Care is seeking a WEEKEND Cook to join our team! You can choose to work EVERY weekend, or EVERY OTHER weekend! Our Senior...

  • Senior Paralegal

    3 weeks ago

    Minneapolis, United States The Cigna Group Full time

    This Senior Paralegal role provides an exciting opportunity to join the Legal Ops & Shared Services team within Cigna’s Legal and Corporate Affairs department. This Senior Paralegal role will primarily support the litigation team in all areas related to corporate health care litigation. Specifically, this individual will partner with internal counsel, work...

  • Caregiver - Beautiful Senior Living Community Brooklyn Park

    3 weeks ago

    Minneapolis, United States Suite Living Senior Care Full time

    Job DescriptionJob DescriptionPOSITION: CAREGIVERCOMPANY: Suite Living Senior CareLOCATION: Brooklyn Park, MNTYPE: Full-time or Part-time AvailableSHIFT(S) AVAILABLE: AM (6am-2pm), PM (2pm-10pm)We are seeking Caregivers to join us at our Brand New Memory Care and Senior Living Community. If you are a CNA or experienced Caregiver, we would love to hear from...

  • Caregiver (NOC Shift) - Senior Living Community

    1 week ago

    Minneapolis, United States Suite Living Senior Care Full time

    Job DescriptionJob DescriptionPOSITION: CAREGIVERCOMPANY: Suite Living Senior CareLOCATION: Spring Lake Park, MNTYPE: Part-time AvailableSHIFT: NOC (10pm-6am)PAY RANGE: $18-20.50/hr (DOE, Negotiable)***We are seeking CAREGIVERS to join us at our Senior Living Community located in Spring Lake Park, MN! Our communities have 32 beds in Memory Care + Assisted...

  • Senior Accountant

    3 days ago

    Minneapolis, United States Koch Trucking , Inc. Full time

    Senior Accountant Stan Koch and Sons Trucking, one of the Midwest's Premier Truckload Carriers is continuing to grow and is looking to add to its staff an Accountant V.The purpose of the this position is to provide accurate timely financial information following GAAP standards for internal and external reporting purposes, and for the employee to perform...

  • Housekeeper - Homewood Suites Edina - Full Time

    1 week ago

    Minneapolis, United States Concord Hospitality Full time

    Are you ready to begin your journey with Concord; a company who believes in and who supports career advancement opportunities for its associates? If so, we may have the perfect position for you!Concord Hospitality is hiring Housekeepers who will be responsible for:Cleaning and servicing assigned guest rooms in a timely and organized manner, following...

  • RCM Representative Senior, Admitting and Registration

    4 weeks ago

    Minneapolis, United States Hennepin County Medical Center Full time

    Hennepin Healthcare is an integrated system of care that includes HCMC, a nationally recognized Level I Adult Trauma Center and Level I Pediatric Trauma Center and acute care hospital, as well as a clinic system with primary care clinics located in Minneapolis and across Hennepin County. The comprehensive healthcare system includes a 473-bed academic medical...