CCMS & Associates is in search of a Senior Workers’ Compensation Adjuster. This is a 1099 remote position. We are seeking a licensed Texas adjuster with 5 years of experience, specializing in lost time workers’ compensation claims. Responsible for investigating and administering assigned Liability and/or Workers' Compensation claims and when warranted pursue litigation and subrogation against third parties. Alternative experiences in liability and casualty claims investigation and handling preferred. Temporary position (to start) within a fast-growing independent adjusting and Third Party Administration firm with potential to convert to a team lead or supervisor upon assessment and performance evaluations. Requirements: + High School Diploma or GED + Bachelor’s degree in related field (preferred); 5 or more years related experience; or equivalent combination of education and experience + TEXAS All Lines Adjuster License with Continuing Education credits in workers compensation + Working laptop computer, high-speed internet, Word, and Excel + Must demonstrate strong time management skills Responsibilities: + Effectively manage workers’ compensation files, including very complex claims + Initiate and conduct investigation in a timely manner + Determine compensability of claims and administer benefits, based on state law and in accordance with established company guidelines + Manage medical treatment and medical billing, authorizing as appropriate + Communicate with claimants, providers, and vendors regarding claim issues + Compute and set reserves within company guidelines. + Maintain diary system for case review and document the file to reflect status and work being performed + Communicate appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns + Conduct file reviews independently + Direct and assist representatives attending hearings or mediations + Adhere to all company policies and procedures + Other duties as assigned Knowledge and Skills: + Technical knowledge of statutory regulations and medical terminology + In-depth assessment and analytical skills + Excellent written and verbal communication, including the ability to convey technical details to claimants, clients, and staff + Ability to interact with persons at all levels in a business environment + Ability to independently and effectively manage very complex claims + Proficient in Word and Excel All candidates must pass a full background check (void in states where prohibited) Powered by JazzHR