CLAYSBURG, Pennsylvania, USA
15 days ago
Insurance Claims Coordinator II
OVERVIEW Responsible for coordinating and supporting workers compensation and or general liability claims to include investigation, evaluation, negotiation and disposition for the organization. Acts as liaison between the organization, claimants, providers and attorneys. RESPONSIBILITIES (other duties may be assigned) 1. Contact the injured party promptly to obtain information necessary to investigate the claim. 2. Conduct a prompt and fair investigation and fact evaluation of the incident. Disposition of the claim in a timely manner. 3. Create and implement action plans for case resolution, including medical management, litigation management, negotiation and disposition in consultation with Defense Counsel. 4. Review claims in order to identify trends or procedures that causes losses for the company. 5. Review and update physician panels. 6. Provide assistance/guidance to the Claims Assistant with the managing of his/her claim workload while providing guidance when necessary. 7. Handle customer complaints with respect to a wide-range of issues. 8. Assist Food Safety and Quality Assurance departments with food/beverage complaints. 9. Process and investigate subpoena requests for police departments, attorneys and the Court. QUALIFICATIONS (Equivalent combinations of education, licenses, certifications and/or experience may be considered) Education • 2 year degree in related field required. Experience • Minimum 3 years’ experience in legal or insurance related field adjusting workers compensation and or general liability claims required. Licenses/Certifications • Must pass and hold adjuster license in the states of PA, WV, VA, MD, NC and Ohio within 1 year of employment. Tools & Equipment • General office equipment
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