Medical Only Adjuster

Essential Duties and Responsibilities include the following. Other duties may be assigned:
•    Processes claims involving minor injuries and/or pay and close claims.
•    Examines claim forms and other records to determine insurance coverage.
•    Ensures that claim file documentation and reserves are current.
•    Reviews and processes medical bills and other claims-related expenses as appropriate.
•    Pays claimant and providers amounts due.
•    Refers claims that require investigation or have more complex medical issues to supervisor or Claim Representative for investigation and continued billing.
•    Services phone calls and disputes over billing in accordance with company protocols.
•    Assists claims examiners with medical bill processing and filing.
•    Provides general clerical support to claim representatives. 
•    Filling of appropriate states forms as required to be in compliance with state reporting requirements.
•    Performs other duties as assigned.

Qualifications 
•    High school Diploma or equivalent is required
•    1-2 years prior experience handling worker’s claims/ or an equivalent combination of training, education and experience. 
•    Adjuster licensing required; (Multiple jurisdictions will be involved, will be required to have a license that will reciprocate to other states.) 
•    Strong organization skills, attention to detail and the ability to multi-task and prioritize work are required. 
•    Analytical thinking skills are needed to properly evaluate complex claims
•    A strong attention to detail is necessary as claims adjusters must carefully review documents and policies
•    Good verbal and written communication skills, as well as interpersonal skills are required, experience with negotiations, knowledge of litigation process is preferred.
•    Ability to listen well and negotiate with constituents is needed. 
•    Ability to speak a second language is an asset
•    Basic computer skills or the ability to quickly learn new software are required
•    A strong work ethic and time management skills is needed, to efficiently handle a caseload ranging from minor to complex claims
•    Ability to establish and maintain good rapport with clients and claimants is needed. 
•    Ability to calculate figures is required 
Physical Demand

While performing the duties of this job, the employee is regularly required to sit; stand; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to walk; reach with hands and arms; and stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include close vision. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

This description is not meant to be all-inclusive and may be modified from time to time at the discretion of management.

Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status.  California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at www.Acrisure.com/privacy/caapplicant.
 

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