Workers Compensation Claims Adjuster

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🔥 3 hours ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

⏰ Full Time

🟢 Junior

📋 Claims Specialist

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Dayforce

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

👥 HR Tech

☁️ SaaS

🤝 B2B

💰 $1G Post-IPO Debt - Dayforce on 2024-03

HR Tech • SaaS • B2B

Dayforce is a cloud-based human capital management (HCM) platform from Ceridian that delivers payroll, HR, workforce management, talent management, benefits administration, time & attendance, and scheduling capabilities. It is offered as a SaaS solution for employers to manage payroll, compliance, recruiting, performance, and workforce processes in a single platform.

📋 Description

• Manage a caseload of moderately complex casualty claims from intake through resolution. • Conduct thorough investigations, assess liability, and evaluate damages using established procedures. • Collaborate with underwriting, legal, and internal/external stakeholders as needed to ensure comprehensive claim evaluation. • Identify and refer potentially suspicious claims to the Special Investigations Unit. • Apply comparative negligence laws and state-specific regulations to claim assessments. • Set reserves, authorize payments, and demonstrate financial acumen within scope of authority. • Utilize technology and data tools to enhance claims processing efficiency and accuracy. • Communicate directly with claimants, legal representatives, and third parties to negotiate fair resolutions. • Maintain detailed and compliant documentation of claim activities and communications. • Participate in team collaboration, problem-solving discussions, and cross-functional coordination. • Support subrogation efforts and risk transfer opportunities to benefit insureds and business partners. • Handle sensitive communications professionally and translate complex information for diverse audiences. • Mentor entry-level claim handlers and share best practices learned through training and experience. • Attend ongoing training and education to maintain licensing and stay current on industry standards. • Independently manage indemnity, medical, and basic arbitration or mediation components of claims with supervisory support. • Must possess or obtain and maintain appropriate state adjuster licenses.

🎯 Requirements

• Associate degree required; bachelor's degree preferred or combination of education and experience. • Typically has 1-4 years of relevant claims handling experience. Conduct independent analysis of contractual indemnification. • Independently execute indemnity, medical, litigation/resolution management. • Proficient with basic computer navigation; ability to use basic software systems/applications (Suite of MS Office Products) and use of internet. • Learn and handle negotiations independently within authority, understand common tactics for moderately complex claim resolution. • Use judgement and effectively utilize the most suitable communication channel while displaying empathy towards all stakeholders. • Knowledge of various types of insurance products and processes. • Conduct thorough investigations; identify key issues and gather evidence. • Provide effective empathetic customer service; handle routine inquiries and issues. • Ability to use a personal computer and other standard office equipment. • Able to use all Microsoft office products. • Ability to sit and/or stand for extended periods. • Required to work on-site as needed. • Ability to travel as necessary. • Ability to work in a fast paced, changing or stressful environment. • Ability to perform work in a noisy/loud work environment. • May be required to have and maintain sufficient home-based internet connection.