Sr. Claims Adjuster
3 days ago
POSITION SUMMARY: Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines.
DUTIES AND RESPONSIBILITIES:
- Effectively manages a caseload of 110 to 160 workers' compensation files, including very complex claims.*
- Initiates and conducts investigation in a timely manner.*
- Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.*
- Manages medical treatment and medical billing, authorizing as appropriate.*
- Communicates with claimants, providers and vendors regarding claims issues.*
- Computes and set reserves within Company guidelines.
- Maintains diary system for case review and documents file to reflect the status and work being performed on the file.*
- Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.*
- Adheres to all Company policies and procedures.*
- Conducts file reviews independently.*
- Other duties as assigned.
EQUIPMENT OPERATED/USED: Computer, 10-key, fax machine, copier, printer, and other office equipment.
QUALIFICATIONS REQUIRED:
Education/Experience : High School Diploma or GED required. Bachelor's degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.
Knowledge, Skills and Abilities :
- Technical knowledge of statutory regulations and medical terminology.
- Analytical skills.
- Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
- Ability to interact with persons at all levels in the business environment.
- Ability to independently and effectively manage very complex claims.
- Proficient in Word and Excel (preferred).
Other Qualifications :
- Texas Workers Compensation License
-
Property Adjuster Specialist
2 days ago
Addison, TX, United States USAA Full timeWhy USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the 1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat...
-
Property Adjuster Specialist
19 hours ago
Addison, TX, United States USAA Full timeWhy USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the 1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat...
-
Property Adjuster Specialist
7 days ago
Addison, TX, United States USAA Full timeWhy USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat...
-
Property Adjuster Specialist
2 weeks ago
Addison, TX, United States USAA Full timeWhy USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat...
-
Property Adjuster Specialist
1 week ago
Addison, TX, United States USAA Full timeWhy USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values - honesty, integrity, loyalty and service - define how we treat...
-
Auto Claims Specialist
1 week ago
Addison, TX, United States Zurich NA Full timeAuto Claims Specialist 128429 Zurich is hiring a Claims Specialist to join our dynamic Auto Claims Team. This role offers an incredible opportunity to grow your expertise by interpreting, investigating, and evaluating auto policies and coverage issues while mastering claims handling and industry best practices. As a Claims Specialist, you will manage auto...
-
Auto Claims Specialist
5 days ago
Addison, TX, United States Zurich NA Full timeAuto Claims Specialist 128429 Zurich is hiring a Claims Specialist to join our dynamic Auto Claims Team. This role offers an incredible opportunity to grow your expertise by interpreting, investigating, and evaluating auto policies and coverage issues while mastering claims handling and industry best practices. As a Claims Specialist, you will manage auto...
-
Auto Claims Specialist
6 days ago
Addison, TX, United States Zurich NA Full timeAuto Claims Specialist 128429 Zurich is hiring a Claims Specialist to join our dynamic Auto Claims Team. This role offers an incredible opportunity to grow your expertise by interpreting, investigating, and evaluating auto policies and coverage issues while mastering claims handling and industry best practices. As a Claims Specialist, you will manage auto...
-
Auto Claims Specialist II
2 weeks ago
Addison, TX, United States Zurich Insurance Group Full timeZurich North America is currently hiring a Litigation Claims Specialist to join our Auto Bodily Injury Team. At Zurich North America Claims, we prioritize work-life balance and flexibility to support your career and personal goals. Our hybrid work model is thoughtfully designed to offer employees flexibility in choosing their preferred work location while...
-
Auto Claims Specialist II
1 week ago
Addison, TX, United States Zurich Insurance Group Full timeZurich North America is currently hiring a Litigation Claims Specialist to join our Auto Bodily Injury Team. At Zurich North America Claims, we prioritize work-life balance and flexibility to support your career and personal goals. Our hybrid work model is thoughtfully designed to offer employees flexibility in choosing their preferred work location while...
