Workers Comp Indemnity Adjuster/Executive Territory Rep (Hybrid)

Main Function

Responsible for independently administering lost time/indemnity workers' compensation claims including but not limited to conducting a thorough investigation, managing medical care, and working towards final claims closure.

Outline of Responsibilities

• Review all new losses for appropriate assignment on date of receipt
• Thoroughly investigate claims and make compensability and coverage decisions through 3-point contact with employee, employer and medical provider.
• Ensure effective communication, both orally and in writing, with clients, injured workers and provider offices.
• Determine subrogation recovery opportunities and handle through conclusion.
• Adjudicate medical bills.
• Proper use of the Pharmacy Benefit Manager Program.
• Review and document all claims correspondence to proactively manage the claims.
• Ensure Indemnity payments are timely and appropriate.
• Estimate and establish reserves on all claims for probable final payout at an Executive Territory Representative level.
• Manage medical care to ensure reasonable and appropriate medical care.
• Proper use of in-house Telephonic Nurse Case Managers
• Maintain a claim follow-up diary system.
• Comply with excess reporting policies.
• Facilitate in-person claim reviews and telecons with clients as required.
• Appropriate use of Allocated Loss Adjustment Expenses in management of claims.
• Document claim activity in file notes including a solid current status and plan of action.
• Provide prompt and efficient service to our clients on all client requests.
• Facilitate Educational Supervisor Seminars for clients
• Properly close all claims once all claims issues are resolved.
• Review new claims, in absence of Manager, and provide direction to the Senior Territory Representative, Territory Representative/Claims Examiners.
• Provide assistance in training and developing Territory Representatives and Claims Examiners.
• Other duties as defined.

Qualifications

Bachelor's degree and five years experience working at a senior level in managing lost time / indemnity workers' compensation claims, and Iowa jurisdiction experience required. Must have or be able to obtain an Iowa adjusting license upon hire. A certificate in related insurance program, preferred. Four years' experience may be considered in lieu of education. Strong understanding of medical information and State Workers' Compensation Acts. The necessary skills to self-supervise all aspects of the position required. Ability to exercise independence and critical thinking skills that lead to appropriate judgment in the management of claims. Further ability to independently multi-task in a faced paced environment required as well. Possess excellent oral and written communication skills, a strong attention to detail, as well as the ability to work well with others and be a positive team player. Adaptability to meet ever-changing needs of clients as well as an intermediate knowledge of Microsoft Office. Routine travel is required.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.

We offer a competitive compensation package, including excellent benefits. Qualified candidates must apply online: Click here to apply https://www.team-iha.org/our-association/employment-opportunities

Pay Range: $90,820 to $136,229 annually, actual compensation is dependent on job-related factors such as experience, education, skills and qualifications for the role.

IHA offers a full range of benefit programs based on eligibility. Click here to review our Benefit Summary.