[Hiring] Medical Only Work Comp Claims Adjuster @Frankenmuth Insurance Company

Role Description

This position can be remote.

Under moderate supervision and following standard procedures with some independent judgment, investigates, evaluates and resolves/disposes of medical only workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage, compensability, liability and damage in accordance with policy provisions by performing the following duties:

• Follows corporate policies, procedures, and fair claims handling practices.
• Investigates claims to determine validity and extent of liability, including:
  • Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others.
  • Reviews and evaluates documentation, including applications, reports, and statements.
  • Monitors appropriate claim outcomes through self-audit process.
• Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues.
• Ensures legal, regulatory and fair claims handling compliance.
• Sets or recommends reserves based on results of claim investigation.
• Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports.
• May provide interaction with insureds, agents, claimants, attorneys, and other service providers, including:
  • Conducts in-depth interviews and/or scene inspections.
  • Attends settlement conferences and/or trials.
• May serve as a member of project teams, contributing to the achievement of project objectives.
• Performs other duties as assigned.

Qualifications

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• The requirements listed below are representative of the knowledge, skill, and/or ability required.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Education/Experience:
  • Level 4: Two to four years related experience and/or training; or associate's degree (A.A.) from two-year college/technical school; or equivalent combination of education and related experience/training.
• A minimum requirement for this position is the ability to work legally in the United States. No visa sponsorship/support is available for this position, including for any type of U.S. permanent residency (green card) process.

Company Description