Claims Adjuster

2 days ago


Chicago, Illinois, United States Chicago Transit Authority Full time
Job Summary

We are seeking a highly skilled Claims Adjuster to join our team at the Chicago Transit Authority. As a Claims Adjuster, you will be responsible for managing cases of employees injured on the job, updating and maintaining investigation reports, medical records, and case notes to determine compensability, and setting reserve levels, monitoring claims costs, and generating payments to service providers and injured employees to cover injury-related costs.

Key Responsibilities
  • Case Management: Manage cases of employees injured on the job, including investigating and evaluating claims, and determining compensability.
  • Claims Administration: Update and maintain investigation reports, medical records, and case notes, and set reserve levels, monitor claims costs, and generate payments to service providers and injured employees.
  • Subrogation: Identify and initiate subrogation activity to recover payment from at-fault third parties.
  • Medical Management: Manage medical care, including coordinating needed services and monitoring appointments.
  • Negotiation: Negotiate claims within designated authority level.
  • Testimony: Testify before the Workers' Compensation Commission on claims denials.
  • Reporting: Prepare comprehensive claims summary reports, settlement recommendations, and status reports to document claims cases.
Requirements
  • Education: Bachelor's degree in Human Resources, Business, or a related field.
  • Experience: Three (3) years of experience managing Illinois Worker's Compensation claims, including some experience working in a union environment and with a Third Party Administrator.
  • Skills: Strong verbal and written communication skills, strong computer skills, ability to collect and analyze facts and information, ability to understand, interpret and follow laws, ordinances, regulations and procedures, ability to establish and maintain effective working relationships with all levels of staff and the public.
Working Conditions
  • Work Environment: General office environment.
  • Travel: Occasional travel to various locations.
Equipment, Tools, and Materials Utilized
  • Software: Personal computer and related software (Microsoft Word, Power Point, Excel), HRIS, and claims software.


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