Adjuster I, Workers' Compensation

3 weeks ago


Knoxville Tennessee, United States Pilot Company (SSC) Full time
Job Description

The purpose of this job is to investigate and resolve incidents of workers’ compensation claims presenting exposure to the company.

Essential Functions

Investigate incidents presenting exposure to the company

Manage, document, analyze, negotiate, and settle claims for resolution

Manage and control claim related documentation including Personally Identifiable Information (PII) and Health Insurance Portability and Accountability Act (HIPAA) related information

Manage litigation to obtain favorable outcome and resolution

Collaborate with defense counsel on litigation closure strategy

Investigate, evaluate, and resolve Medical Only and/or Lost Time Employee Injury claims with independent settlement authority

Monitor third-party administrator (TPA) to ensure claims are processed efficiently

Provide reserve recommendation to PFJ corporate management for cases processed by TPA and applicable in-house claims

Focus on loss prevention and hazard correction during claim handling

Resolve conflicts with claims in collaboration with senior or more tenured adjuster

Model behaviors that support the company’s common purpose; ensure guests and team members are supported at the highest level

Ensure all activities are in compliance with rules, regulations, policies, and procedures

Complete other duties as assigned



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