Claims Adjuster Workers Compensation Jobs in Texas

Provide WC claims’ management education and WC regulatory updates to local business units.

Bachelor’s degree in Risk Management, Finance or Nursing background preferred

Ability to effectively work and collaborate with people with a wide range of skills, experience, cultures, and capabilities

Other duties as directed by management

Minimum seven (7) years of experience managing WC claims

WC technical knowledge and WC case law in multiple jurisdictions from Ohio to California

Manage all aspects of claims to resolution in accordance with jurisdictional requirements

Obtain appropriate state adjuster certification and continuing education credits

Establish appropriate claim reserve and manage reserve adequacy throughout life of claim

Negotiate skillfully in difficult situations to win concessions without damaging relationships

Minimum 3 years progressive work experience in administrative role

Bachelor's Degree in relevant field or equivalent work experience

Process payment of medical bills and invoices, meeting all statutory timeliness requirements

Minimum of one year of progressive office administration experience

Knowledge of workers’ compensation terminology preferred

Communicate with injured workers and service providers to facilitate claims administration

Provide injured workers with information about the workers’ compensation process

Handle multiple priorities simultaneously and effectively prioritize tasks to meet deadlines

Education & Licensing: 3+years of claims management experience or equivalent combination of education and experience required.

Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

Professional certification as applicable to line of business preferred.

Bachelor's Degree/or equivalent in Risk Management, Business, Finance, or related field.

Verbal and written communication skills necessary to communicate with all levels of management and third-party providers

Apply aggressive litigation cost management strategy on individual WC claim files

Adhere to quality management and compliance protocols

Ensure WC vendors are complying with service instructions and guidelines and escalate specific issues to Manager

Confirm initial and ongoing TPA reporting of WC claims requiring excess notification, and escalate claims meeting defined criteria to Manager

Prior experience handling claims reviews and litigation management

2+ years of experience handling Workers Compensation claims from inception to close including those in litigation

Active Adjuster's License in Texas