Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution.
Complete quality investigations by gathering pertinent information. Reviews and evaluates coverage and/or liability. Secures necessary information (i.e., reports, policies, releases, statements, or other documents) in the investigation of claims.
Conduct a thorough analysis of liability and continually assess exposure and evaluate for accurate reserves.
Works toward the resolution of claims files and takes full charge of claim from inception to resolution.
Will affect settlements/reserves within prescribed limits and submits recommendations to supervisor on cases exceeding personal authority.
Ensures that claims payments calculated accurately and are issued in a timely and accurate manner.
Ensures compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements.
Maintains a diary to follow claim progress on all claims.
Determine liability for permanent disability, mitigation of costs and resolution of claim.
Oversee litigation and coordination of claim with defense team.
Requirements
Communication Skills:
Ability to provide professional and friendly customer service
Demonstrated ability to manage relationships in a fast-paced environment along with problem solving and decision-making skills to work through a variety of challenging situations.
Ability to respond to requests effectively and efficiently.
Listens effectively and clearly expresses ideas and recommendations.
Proficient in communicating effectively and clearly, both orally and in writing.
Capable of carrying out detailed written or verbal instructions.
Technical Expertise:
Complete understanding of all Microsoft Office applications.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Proficient in the operation of computer equipment and applications.
Customer Service:
Responds timely and consistently with all communication.
Builds credibility with internal and external customer.
Creates customer satisfaction.
Familiar with the company tools and is comfortable reviewing with all levels of management in a professional manner.
Education and Experience
Bachelor's degree preferred.
Must have 1-3 years of experience managing lost time workers' compensation claims.
Familiarity with TPAs strongly preferred
Holds the appropriate state adjusting licenses (NV)
Familiarity with jurisdictional state and federal workers' compensation laws and regulations
Multiple jurisdiction experience is preferred.
Candidates will be required to have strong customer service, communication (verbal and written), time management and organizational skills.
Must demonstrate an ability to work independently.
Must demonstrate a strong knowledge of computers and software.
Work Environment/Hours
This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Team Environment
Verbal Contact with Others
Standard Work Hours: Mon-Fri, 8:30a-5p (37.5 Hours per week) Additional hours will be worked based on business needs. Adjustment from 8:30a-5pm per arrangement with Management.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is required to frequently sit; work using a computer; interact with customers (by phone and/or email); use hands to finger, handle or feel; and reach with hands and arms. Travel - Minimal travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected.
Other Duties
Please no
Additional Information
Job Description
About Acrisure
A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services - and more.
In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.
Job Summary
Acrisure is seeking a Lost Time Adjuster to join our growing Workers' Compensation team!
This individual will effectively review Nevada Lost Time claims and determine appropriate action for resolution.
This role requires excellent communication and customer service skills, strong motivation and organizational skills.
Acrisure · 8918 Spanish Ridge Ave, Ste 200 - Las Vegas, NV