Claims Adjuster Associate - Department of Finance

About the position This position is responsible for managing an assigned caseload of workers’ compensation claims. Essential functions include contacting injured worker, employer and all necessary parties to determine coverage, compensability and benefits. This role involves managing an active caseload of Workers’ Compensation claims. Initially, the caseload will consist of a smaller number of lower-severity claims, allowing for skill development and familiarity of processes. Over time, there may be opportunities to handle more complex cases. Candidates who demonstrate strong performance and interest may have the opportunity to apply for advancement into a Senior Claims Adjuster position. The position will evaluate losses, set and monitor reserves, issue benefits and negotiate settlements. As a Claims adjuster you will interact with injured workers, the City Attorney's office, medical professionals as well as claimant's attorneys during the course of your investigation.

Responsibilities

• Investigates and confirms or denies coverage and compensability of claims presented through contact with claimant, insured and other involved parties
• Regularly reviews and makes appropriate decisions regarding medical bills presented, wage claims and other daily claims items to keep file up to date
• Manages the medical aspects of assigned claims with a focus on return to work and end of treatment
• Refers appropriate files for task assignments to approved vendors for medical management, special investigative needs, etc., within assigned authority. Monitors status and quality of work performed
• Make recommendations to the Worker’s Compensation Supervisor on claims issues which exceed personal authorization
• Properly evaluates exposures on claims and takes appropriate reserving action in accordance with company guidelines, applicable state requirements, and within designated authority level
• Negotiates claims to a conclusion, within assigned authority level
• Effectively manages claims in litigation
• Controls expenses on all worker’s compensation claims
• Works with the Subrogation Analyst to maximize all recoveries on eligible claims

Requirements

• At least two (2) years of experience adjusting Workers’ Compensation insurance claims
• Requires a valid Driver's License at the time of application
• Licenses and certifications must be kept current as a condition of employment.

Nice-to-haves

• Extensive knowledge of Colorado’s Workers’ Compensation Act, Rules of Procedure and significant Workers’ Compensation caselaw
• Experience with Riskonnect Risk Management Information System (formerly known as CS STARS and STARS Enterprise)
• An ability to reprioritize work many times a day in response to new developments and communication on assigned WC claims
• A “customer service” mindset for handling claims involving fellow employees of the City
• Excellent communication skills for keeping various involved internal and external customers informed and updated regarding claims handling status and plans
• Excellent writing skills for internal file documentation and external written communication
• Bachelor's Degree in Political Science, Public Administration, Accounting, Management or a related field preferred, but not required.
• One (1) year of the appropriate type and level of experience may be substituted for each required year of post high school education
• Additional appropriate education may be substituted for the minimum experience requirements

Benefits

• A guaranteed life-long monthly pension, once vested after 5 years of service
• 457B Retirement Plan
• 140 hours of PTO earned within first year
• 12 paid holidays, 1 personal holiday, 1 Wellness Day and 1 volunteer day per year
• Competitive medical, dental and vision plans effective within 1 month of start date

Apply tot his job Apply To this Job