MUST HAVE MI STATE ADJUSTER LICENSE
Description
The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department.
Position requires at a minimum of a MI State Adjuster license, candidate must be able to provide proof.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
- Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim
- Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies
- Establishes reserves and authorizes payments within reserving authority limits
- Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim
- Coordinates early return-to-work efforts with the appropriate parties
- Manages subrogation and litigation of claim as it applies
- Manages potential claim recoveries of all types
- Reports claims to the excess carrier when applicable
- Communicates claim status with the customer and claimant
- Adheres to client and carrier guidelines and participates in claims review as needed
- Develops and maintains professional customer relationships
- Complies with rules and regulations of applicable state
- Additional duties as assigned
KNOWLEDGE & SKILLS:
- Excellent written and verbal communication skills
- Ability to assist team members to develop knowledge and understanding of claims practice
- Ability to identify, analyze and solve problems
- Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
- Strong interpersonal, time management and organizational skills
- Ability to work both independently and within a team environment
- Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers’ Compensation
EDUCATION & EXPERIENCE:
- MI Adjuster License and MI Workers Compensation proficiency
- Bachelor's degree or a combination of education and related experience
- Minimum of 3 years’ industry experience and claim handling
- Self-Insured Certificate preferred
- State Certification or license as an experienced claims adjuster
- Current license or certification in Workers’ Compensation must be maintained throughout employment
Pay: $75,000.00 - $85,000.00 per year
Benefits:
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Work from home
Education:
Experience:
- Adjusting experience and claim handling: 3 years (Required)
License/Certification:
- Self-Insured Certificate (Required)
- MI Adjuster License (Required)
Work Location: Remote
