Senior Claims Adjuster

Job Summary: The Senior Claims Adjuster will investigate, evaluate, dispose, and settle workers’ compensation claims and highest exposures in an autonomous environment. This includes the investigation, determination and evaluation of coverage, compensability, and reserving. Candidates must have Longshore/Maritime workers' compensation experience. Who is the Ideal Candidate? The ideal candidate for this role should have a familiarity with standard concepts, practices, and procedures within the claims management field. They should possess the experience and judgment to interpret policies and procedures as established by senior management. This person should feel comfortable working autonomously and empowered to make decisions on goal planning. They should have the ability to understand written and oral communication and to interpret documents, such as workers’ compensation regulations and workers’ compensation forms, medical records, and legal reports. Essential Duties & Responsibilities ·      Use sound judgment to assess claim exposure, determine next steps, and resolve claims appropriately.·      Work closely with all parties involved in the claims process.·      Clearly communicate action plans to move claims to resolution.·      Maintain expert knowledge of claims under the federal workers’ compensation system.·      Handle claims in line with client and corporate policies, best practices, and all legal, regulatory, and ethical requirements.·      Comply with carrier reporting and threshold requirements.·      Maintain a timely diary and manage a full caseload, including higher-severity claims.·      Meet with local members to support operational excellence in claims and maintain strong member engagement.·      Provide 24-hour emergency on-call coverage, as assigned.·      Perform other duties as assigned. Core Competencies ·      Proficiency in a variety of claims management concepts and practices and possess knowledge of general insurance procedures and workers’ compensation benefits, preferably under the Longshore and Harbor Workers Compensation Act.·      Excellent time management and organizational skills and the ability to multitask.·      Strong interpersonal skills and work collaboratively with others to achieve a common goal.·      Must be comfortable making timely decisions and exhibit sound and accurate judgement.·      Knowledge of Claims Management Systems and Microsoft Office Suite. Education ·      Bachelor’s degree is preferred or relevant work experience.·      3+ years of related claims experience, Longshore experience required.