TAJ Health Staffing Hiring for Liability Claims Adjuster at Remote Full Time

Description:

PRIMARY PURPOSE: To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.

Assesses liability and resolves claims within evaluation.

Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

Manages subrogation of claims and negotiates settlements.

Communicates claim action with claimant and client.

Ensures claim files are properly documented and claims coding is correct.

May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Supports the organization’s quality program(s).

Job Types: Full-time, Contract, Temporary

Pay: $35.00 – $39.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 8 hour shift
• Day shift

Education:

• High school or equivalent (Preferred)

Experience:

• General Liability: 3 years (Preferred)
• Bodily Injury: 3 years (Preferred)

License/Certification:

• Adjuster’s License (Preferred)

Work Location: Remote