Workers Compensation Claims Adjuster Resume Samples

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JP
J Price
Jacky
Price
350 Alvera Port
Los Angeles
CA
+1 (555) 853 4993
350 Alvera Port
Los Angeles
CA
Phone
p +1 (555) 853 4993
Experience Experience
Los Angeles, CA
Workers Compensation Claims Adjuster
Los Angeles, CA
Zulauf-Swaniawski
Los Angeles, CA
Workers Compensation Claims Adjuster
  • Continually assess exposure and evaluate for accurate reserves
  • Prepare Large Loss Reports and maintain ongoing claim updates
  • Complete quality investigations by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.)
  • Review, process and conclude Workers’ Compensation claims or those limited in exposure but occasionally complex in nature
  • Oversee and direct claims, directing and controlling the work and expenses of investigative services or attorneys
  • Conduct a thorough analysis of the claim; continually assess exposure and evaluate for accurate reserves
  • Eligible to Work from home 5 out of every 10 days after completing 90 days of employment contingent on the supervisors’ approval
Phoenix, AZ
Workers Compensation Claims Adjuster Senior
Phoenix, AZ
Lindgren-Kling
Phoenix, AZ
Workers Compensation Claims Adjuster Senior
  • Documents all correspondence, reports, discussions and decisions
  • Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions
  • Knowledge of claim procedures, policies, technology, state and federal laws and insurance regulations
  • Insurance coursework (e.g. IIA, CPCU, SCLA and AEI) is beneficial
  • Good knowledge of insurance theory and practices; insurance contracts and their application
  • Oversee and direct a majority of litigated or potentially litigated claims, directing and controlling the work and expenses of investigative services or attorneys
  • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud and resolution potential
present
Dallas, TX
Senior Workers Compensation Claims Adjuster
Dallas, TX
Beer-Abbott
present
Dallas, TX
Senior Workers Compensation Claims Adjuster
present
  • Interacts extensively with various parties involved in the claim process
  • Will demonstrate complete knowledge of the claim file process through presentation of actions and responses to client questions
  • Documents and communicates all claim activity timely and effectively and in a manner which supports the outcome of the claim file
  • Review, process and conclude moderate severity claims that may be limited in exposure but occasionally complex in nature
  • Verifies coverage and policy conditions
  • Completes quality investigation by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.)
  • Determines if subrogation exists and takes steps necessary to initiate recovery efforts
Education Education
Bachelor’s Degree
Bachelor’s Degree
Drexel University
Bachelor’s Degree
Skills Skills
  • Conscientious about the quality and professionalism of work product and relationships with co-workers and clients
  • Provide mentoring services and share acquired knowledge and skills with colleagues either through scheduled formal or informal meetings
  • Able to prepare and make exceptional presentations to internal and external customers
  • Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadline
  • Demonstrated commitment to claims career
  • Willing to take ownership and tackle obstacles to meet our quality standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation
  • Use analytical skills to find mutually beneficial solutions to claims and customer issues
  • Important information: This position is recruited for by a remote Kelly office, not your local Kelly branch. Please submit your resume to be considered for this position by pressing the “SUBMIT RESUME” button below. If you have questions about the position, you may contact the recruiter recruiting for this position (DANR020@Kellyfinance.com), however, your resume should be uploaded via the “SUBMIT RESUME” button included within
  • Develop content and deliver training to all levels of CPC Staff in coordination with the Medical Reimbursement Analysis Unit (MRAU)
  • Manage special projects and perform complex duties related to the Bill Review or Scan/Index functions
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6 Workers Compensation Claims Adjuster resume templates

1

Workers Compensation Claims Adjuster, Hawaii Resume Examples & Samples

  • Complete and monitor timely WC payments/state filings
  • Manage litigation cases including controlling/directing outside attorneys, assisting in discovery/trial preparation and strategy
  • Evaluate claims for potential third party or subrogation recovery
  • Effective influence skills
  • Demonstrate strong leadership abilities
  • Basic knowledge of claims process
  • Ability to work well in a team, providing assistance to fellow associates and representing the mission of the unit
  • Show dependability
2

Workers Compensation Claims Adjuster Resume Examples & Samples

  • 2 years Work Comp claims management experience required
  • PC literate, including Microsoft Office (Word, Excel)
  • Knowledge of claims administration, case management and cost containment solution as applicable to Workers' Compensation
3

Workers Compensation Claims Adjuster Senior Resume Examples & Samples

  • Able to clearly communicate concise action plans, and present plans for moving the case to conclusion
  • Demonstrated ability to comply with carrier reporting and threshold requirements
  • Able to recognize and pursue excess insurance recoveries. Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity
  • 5 or more years related claims experience required
4

Workers Compensation Claims Adjuster Resume Examples & Samples

  • Incumbents at this level should be able to work at full case load capacity
  • Minimum of 3 years related claims experience required
  • Knowledge of accepted industry standards and practices
5

Workers Compensation Claims Adjuster Resume Examples & Samples

  • 3 month contract, WITH the potential for Full Time Conversion
  • Handle all aspects of workers compensation/lost time claims from set up to case closure
  • Conduct 3 part/ongoing investigations, administer statutory benefits and notices, ensure reserve adequacy, control vendors, manage medical, legal activity, conduct settlement negotiations, and ensure compliance with customer service requests including Special Claims Handling procedures
  • Work with in-house Technical Assistants, Special Investigators, Nurse Consultants, Telephonic Case managers as well as Team Supervisors to exceed customer expectations for exceptional claims handling service
  • Ideally 3+ years of handling complex workers compensation cases
  • Requires extensive knowledge of local workers compensation statutes and regulations
  • Conscientious about the quality and professionalism of work product and relationships with co-workers and clients
  • Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadline
6

Workers Compensation Claims Adjuster Resume Examples & Samples

  • Review, process and conclude moderate severity claims that may be limited in exposure but occasionally complex in nature
  • Verifies coverage and policy conditions
  • Completes quality investigation by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.)
  • Fulfill state licensing agreements/requirements (if applicable) and apply knowledge of state laws and re Ability to manage relationships in a fast paced environment, while demonstrating persistence along with problem solving and decision making skills to work with customers through a variety of challenging situations
  • Knowledge of claim procedures, policies, technology, state and federal laws and insurance regulations
  • Experience with Workers Compensation Claims – lost time claims required
  • Ability to multi-task and handle large volumes of work in a short period of time
  • Bachelor's degree preferred; however employee should possess such skills and knowledge as are normally gained in the successful completion of a four-year college program
  • Minimum of five years' experience handling workers compensation claims
  • Knowledge of Microsoft Office Applications and ability to learn new software programs
  • NY Claims handling experience
7

Workers Compensation Claims Adjuster Resume Examples & Samples

  • Review, process and conclude high exposure liability claims or those limited in exposure but occasionally complex in nature
  • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud and resolution potential
  • Continually assess exposure and evaluate for accurate reserves
  • Prepare Large Loss Reports and maintain ongoing claim updates
  • Complete quality investigations by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.)
  • 2+ years experience in job-related functions
  • Maintain valid adjusters’ license(s) in states assigned or an ability to obtain same
  • Ability to manage relationships in a fast paced environment, while demonstrating persistence along with problem solving and decision making skills to work with customers through a variety of challenging situations
  • NH and VT Workers' Compensation expereince and license is preferred
8

Workers Compensation Claims Adjuster Resume Examples & Samples

  • Reserve practices
  • IME practices
  • Investigation protocols
  • MUST have
  • Managerial experience over workers compensation adjusting departments/desk
9

Workers Compensation Claims Adjuster Resume Examples & Samples

  • Fulfill state licensing agreements/requirements (if applicable) and apply knowledge of state laws and regulations pertaining to the insurance industry
  • 5 to 6 years’ experience in handling workers comp claims
  • Maintain valid adjusters' license(s) in states assigned or an ability to obtain same
10

Workers Compensation Claims Adjuster Resume Examples & Samples

  • Review, process and conclude Workers’ Compensation claims or those limited in exposure but occasionally complex in nature
  • Oversee and direct claims, directing and controlling the work and expenses of investigative services or attorneys
  • Conduct a thorough analysis of the claim; continually assess exposure and evaluate for accurate reserves
11

Senior Workers Compensation Claims Adjuster Resume Examples & Samples

  • Will demonstrate complete knowledge of the claim file process through presentation of actions and responses to client questions
  • Processes claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements
  • Appropriately licensed and/or certified in all states in which claims are being handled