[Hiring] Workers' Compensation Adjuster @Davies

Role Description

We are on the lookout for an experienced Workers' Compensation Adjuster to join our team. You will be responsible for investigating and evaluating losses while developing a plan of action to bring claims to proper resolution in a timely manner.

This role does require you to live in New Mexico and have a New Mexico adjuster license, with a minimum of 5-7 years of experience handling Workers' Compensation claims.

Key Responsibilities

• Determines extent of insurance coverage and compensability on each filed claim
• Investigates claims, including interviewing employees, employers, and witnesses
• Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
• EDI and CMS/Section 111 reporting
• Utilizes appropriate preferred vendors
• Presents thorough and accurate reports to client and/or carrier on claims investigations/situations
• Negotiates settlements for resolutions with claimants and their attorneys
• Maintains control of litigation activities and costs per account requirements
• May be asked to mentor, train and/or share expertise with other Davies staff
• Attends meetings; conferences; workshops or training sessions; and reviews written material to maintain current knowledge on principles, practices and new developments in assigned work areas
• Maintains and meets specific licensing requirements
• Responds to client questions and comments in a courteous and timely manner
• Is responsible for catastrophic losses, complex litigation, and other sensitive issues
• All other duties as assigned

Qualifications

• Ability to understand and follow oral and/or written policies, procedures and instructions
• Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines
• Ability to conduct investigations in multi-party situations
• Ability to use standard or customized software applications appropriate to assigned tasks
• Ability to prepare and present accurate, reliable and factual reports with recommendations
• Thorough knowledge of current principles and practices associated with claims investigations, adjustment and related practices
• Extensive knowledge of medical and legal terminology with a thorough understanding of Legal principles/litigation management
• Ability to handle confidential information
• Ability to communicate effectively with others both orally and in writing
• Ability and willingness to learn quickly and utilize new skills because of rapidly changing information and/or technology
• Ability to comprehend multi-state laws and regulations to assist other offices, as necessary

Benefits

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage
• Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.