[Hiring] Medical Only Occupational Accident Claims Adjuster @Transtar Insurance/Bluestar Claims

Role Description

The Occupational Accident Claims Adjuster is responsible for the investigation and adjustment of assigned Occupational Accident claims. At Blue Star, our expectation is that you:

• Investigate and adjust occupational accident claims in accordance with established claims handling procedures using Blue Star guidelines and supervision.
• Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing occupational accident claims.
• Authorize and make payment of occupational accident claims utilizing our claim processing protocol in accordance with policy language and within authority levels.
• Process medically necessary and related bills according to Policy provisions.
• Make supported and educated claim decisions timely.
• Forecast potential exposure for reserving claims.
• Have continued contact with policyholders.
• Negotiate settlements, if appropriate pursuant to the terms of the policy and within authority levels.
• Deliver quality claim service to clients and be responsive to client needs.
• Familiarize yourself with jurisdiction challenges you may face and be mindful of potential exposure.
• Manage your time efficiently and utilize your attention to detail to every claim you work on.
• Use established forms and modify letters pursuant to Policy provisions.
• Review and document medical records outlining treatment plan, restrictions and plan of action.
• Able to identify mechanism of injury vs symptoms vs non-related conditions.
• Policy review and administration of benefits pursuant to policy terms.
• Manage claim to optimal resolution; paying for what we owe with relation to the policies we administer.
• Establish valuable relationships with our Insureds / Motor Carriers / Brokers / Providers / Preferred Vendors.
• Work as a team player.
• Be flexible, use initiative and work with minimum of direct supervision.
• Use discretion and confidentiality required.
• Clearly communicate verbally and/or in writing both internally and externally.
• Be organized, a self-starter and prioritize your duties with attention to detail.
• Perform other duties as assigned.

Qualifications

• High school diploma or equivalent.
• At least two years of experience in some manner of medical type claims, claims adjusting, paralegal or legal assistant.
• Microsoft Office experience.
• Completion of our pre-employment assessment via the link below: Pre-employment Assessment

Requirements

• Location: PHOENIX, Arizona (Remote).
• Employment Type: Full-Time.
• Minimum Experience: Experienced.
• Compensation: $45,000 to $65,000.

Benefits

• Competitive salary and potential performance-based bonuses.
• Medical, dental, and vision insurance.
• 401(k) with company match.
• Paid time off and holidays.
• Professional development opportunities.
• A supportive, collaborative work environment.