Questpro is partnered with a leading Workers' Compensation carrier in Baton Rouge, Lousiana to find a Workers' Compensations Claims Adjuster.

This is a hybrid role, 4 days in office with 1 day WFH. Flexible schedule and only a 37.5 hour work week.

The company provides excellent training and administrative & leadership support. Low claim count and a cohesive team environment, with generous benefits & PTO.

JOB SUMMARY:

Provides quality investigation and analysis to adjust workers compensation claims to proper conclusion, serves customers by establishing customer relationships and determining/documenting loss; resolving claims while ensuring legal compliance.

ESSENTIAL FUNCTIONS:

·        Conducts complete investigation of losses through appropriate techniques including interviews, recorded statements, documentation/date gathering and securing/preserving evidence

·        Evaluates liability and damages; identifies subrogation opportunities or suspicious claims

·        Develops strategy and negotiates claims to a timely conclusion, properly applying company policies and procedures

·        Initiates calls to health care providers following up on causation, treatment plan, medical records and final medicals reports

·        Works with injured employees and employers for return to work information, wage information and personnel records

·        Gathers records and expert information by contacting and interviewing medical providers and employers

·        Coordinates claims by obtaining, providing and exchanging information with any third parties

·        Determines need for technical experts and monitors and controls their costs

·        Prepares timely, concise reports as required

·        Verifies, analyzes and correctly applies coverage

·        Ensures timely and accurate reserves

·        Responds to inquiries regarding medical payments, bills and fee schedule

·        Keeps agents and insurers advised of file status and other matters as required

·        Meets with agents, insurers, policyholders, etc. as needed

·        Ensures legal compliance by following guidelines, contracts and state and federal insurance regulations

·        Testifies at trial on OWC, District court issues

·        Coordinates medical cost projection, annuities and Medicare Set Asides with prospective vendors

·        Contributes to team effort by accomplishing related results as needed

·        Code of Conduct: You will at all times conduct yourself in a professional and ethical manner in or away from the office. You are an extension of the organization and your actions should always reflect positively on the company.

REQUIRED QUALIFICATIONS:

·        Excellent computer skills using Microsoft Word, Excel and Outlook

·        Good verbal and written communication skills

·        Must be able to handle multiple tasks, take initiative and work independently

·        Ability to deal effectively and professionally with coworkers, clients, injured workers and vendors that may have highly varies back grounds, including difficult and confrontational people

Apply today or schedule a meeting directly with the Recruiter.

https://calendly.com/questproelder/louisiana-adjuster