Senior Claims Adjuster

POSITION:                    Claims Adjuster

DEPARTMENT:           Claims Management Division

REPORTS TO:                 Manager - Claims Management Division

Position Requirements:

·        High school graduate required; BA/BS degree preferred.

·        Minimum 3 years Maine Workers' Compensation claim adjusting or paralegal experience necessary. 

·        Maine Workers' Compensation adjusters’ license required.

·        Highly developed organizational skills and ability to establish priorities. Mathematical/accounting aptitude and excellent analytical, problem-solving abilities required.  Ability to anticipate needs and exercise independent judgment.

·        Strong interpersonal skills to deal effectively with all levels of the organization, the public and customers with tact and diplomacy

Primary Accountabilities:

·        Gains basic knowledge of Department Errors and Omissions Exposures and implementation of Department E&O Procedures.

·        Ensures optimum performance in this function and recommends and implements techniques to increase productivity or department procedures. 

·        Develops and maintains an image of corporate excellence and teamwork with emphasis on professional and credible customer service and company relations.

Accurate claims adjudication by assessing all information to determine compensability:

·        Effective communication and negotiation skills

·        Creative analytical problem solving skills

·        Ability to manage multiple priorities in a fast paced and dynamic environment

·         Ability to speak and present to various sized groups

·        Interfaces with Self Insured Management Team, claims management division personnel, insureds, health providers and attorneys. Partners with employer in effective claims management.

·        Reviews and authorizes payments.

·        Complies with all state mandated and contractual requirements. 

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Positive and effective co-worker relations:

• Focus on team goals and objectives
• Courteous and considerate communications
• Accurate assistance and support to others as needed.