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Workers' Compensation Lost Time Adjuster

Category: Other
Description:

WORKERS' COMPENSATION LOST TIME ADJUSTER: PG006:  $56,320 – $70,400

THE PURPOSE OF THIS POSITION IS TO MANAGE WORKERS’ COMPENSATION CLAIMS WHERE LOST WAGES MAY BE DUE, AND DETERMINE COMPENSABILITY. THIS IS ACCOMPLISHED BY INVESTIGATING FILES THROUGH A RECORDED STATEMENT, PERFORMING INTERVIEWS, REVIEWING MEDICAL NOTES, ACCEPTING OR DENYING CLAIMS, CALCULATING PAY COMPENSATION, ASSIGNING OUTSIDE VENDORS WHEN NEEDED, ATTENDING MEDIATIONS AND HEARINGS, MONITORING AND ADJUSTING RESERVES ON CLAIMS, HANDLING AND REVIEWING INCOMING MAIL, FILING APPROPRIATE FORMS, AND ACQUIRING, REPORTING CLAIMS TO REINSURANCE WHEN NECESSARY AND MAINTAINING ADJUSTER LICENSES. OTHER DUTIES INCLUDE RESPONDING TO INQUIRIES, VISITING MEMBERS WHEN REQUESTED, AND COORDINATING AND SCHEDULING DEPARTMENT CONTINUING EDUCATION COURSES.

IF YOU MEET THE REQUIREMENTS AND ARE INTERESTED IN BEING CONSIDERED FOR THIS POSITION PLEASE FOLLOW THE APPLICATION PROCESS AT THE LINK BELOW. 


 

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RESPONSIBILITIES/REQUIREMENTS: MANAGES CLAIMS BY MONITORING AND PAYING MEDICAL BILLS; DETERMINING AND CALCULATING VARIOUS TYPES OF PAYMENT; ASSIGNING APPROPRIATE VENDORS; FACILITATING DOCTORS’ ORDERS; OVERSEEING RESERVE ADEQUACY UNTIL CLOSURE; MAINTAINING COMPUTER NOTES, MAINTAIN CLAIM DIARY AND DOCUMENT CONTACT WITH EMPLOYER; MONITORING INCOMING CORRESPONDENCE; CONCLUDING CLAIMS BY PAYING PPD OR SETTLEMENT; ATTENDING MEDIATIONS AND HEARINGS; REPORTING PER REQUIREMENTS; AND REQUESTING SETTLEMENT AUTHORITY. OVERSEE CLAIMS INVESTIGATION BY UNDERSTANDING CHANGING CASE LAWS, MEDICAL TERMINOLOGY, AND REPORTS; COMMUNICATING EFFECTIVELY WITH MEMBERS, INJURED EMPLOYEES, ATTORNEYS AND VENDORS; CONTACTING INVOLVED PARTIES WITHIN 24 HOURS; AND DETERMINING COMPENSABILITY ON A CLAIM WITHIN 14 DAYS. PREPARE AND FILE NECESSARY PAPERWORK BY FILING APPROPRIATE FORMS WITH NCIC; AVOIDING SANCTIONS BY THE STATE; RESPONDING TO FORMS OR MOTIONS FILED BY PLAINTIFF; AND MAINTAINING CONTACT WITH DEFENSE ATTORNEY TO ENSURE FORMS AND MOTIONS ARE FILED. PERFORMS ADDITIONAL ADMINISTRATIVE DUTIES BY FURNISHING FILE MATERIAL TO OPPOSING COUNSEL PURSUANT TO NCIC RULES; RESPONDING TO CLAIM INQUIRIES; SENDING MEDICAL BILLS FOR FEE SCHEDULING; REQUESTING BILLS; AND GENERATING CORRESPONDENCE AS NEEDED. OVERSEES EDUCATION AND TRAINING BY ATTENDING SEMINARS AND WORKSHOPS TO ENHANCE WORKERS’ COMPENSATION ABILITY; MAINTAIN CE HOURS; PROVIDING TRAINING TO MEMBERS; PREPARING PRESENTATIONS; MENTORING OTHER ADJUSTERS; IDENTIFYING COURSES OR SEMINARS FOR TRAINING; ATTENDING COURSES AS DIRECTED; AND UNDERSTATING POLICIES AND PROCEDURES, CLAIM HANDLING GUIDELINES AND PROCEDURES.

 

MINIMUM QUALIFICATIONS: BACHELOR'S DEGREE OR EQUIVALENT IN MANAGEMENT, MARKETING, POLITICAL SCIENCE OR RELATED FIELD. OVER FOUR YEARS OF EXPERIENCE HANDING WORKERS’ COMPENSATION CLAIMS; MEDICAL ONLY AND/OR LOST TIME. MUNICIPAL EXPERIENCE OR INSURANCE EXPERIENCE A PLUS. HARDWORKING AND A STRONG WORK ETHIC; SELF-STARTER. CANDIDATE MUST HAVE ADVANCED KNOWLEDGE OF OFFICE PRODUCTS INCLUDING WORD, EXCEL, AND POWER POINT AND EXCELLENT WRITING SKILLS. STRONG INTERPERSONAL SKILLS AND ABILITY TO BUILD RAPPORT WITH MEMBERS AND FELLOW EMPLOYEES. ABILITY TO EXERCISE CONSIDERABLE TACT, COURTESY AND DISCRETION IN FREQUENT CONTACT WITH MEMBERS, PUBLIC OFFICIALS, MUNICIPAL MANAGERS AND OTHERS. MUST HAVE INITIATIVE, ASSERTIVENESS AND BE A CREATIVE SOLUTION SEEKER.

 

SKILLS/CERTIFICATIONS/LICENSE REQUIRED: VALID CLASS C DRIVER'S LICENSE. NC ADJUSTER LICENSE. THIS POSITION REPORTS TO MANAGER OF WORKERS' COMPENSATION CLAIMS.

 

DEADLINE: NOVEMBER 1 OR UNTIL POSITION FILLED.

Employer: North Carolina League of Municipalities (NCLM)
Expires: 11/18/2019
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