Commercial Lines Worker’s Compensation Adjuster

CHARLOTTE, NC
 
System Search is currently recruiting for Commercial Lines Insurance Account Managers for Charlotte, NC.

Responsibilities of the Commercial Lines Account Manager include: 

 
• Handles workers’ compensation claims caseload from inception to final settlement from original set up to end of claim
• Responsible for performing a factual investigation of claim.
• Sets reserves and determine compensability.
• Communicates daily with claimants, medical personnel, and representatives from housing authorities for updates.
• Pays weekly lost time claims and medical bills.
• Assigns rehabilitation referrals and legal representation as needed.
• Coordinates with nurse case managers, vocational counselors, attorneys, and professional surveillance services to bring claims to a conclusion.
• Updates claims information into Riskmaster Claim’s System to include medical notes and daily activity.
• Transmits medical bills to bill review vendor, scan, and attach medical bills to claim.
• Subrogation against third parties.
• Attends IC hearings or mediations, if required.
• Settles claims within established dollar authority – $50,000 (settlement/reserve authority established by management). All claims above settlement authority are approved by Sr. Mgr.
• Closure of claim (and all items necessary for closure, i.e., payment, forms, hard copy of file).
• Transmits Medicare Secondary Payer through ISO Navigator.
• Provides status of claims at staff meetings and board meetings when requested.
• Attends educational seminars, safety seminars, and classes as assigned.
• Performs “Special Project” work when requested by Management.

 
Ideal Requirements of the Commercial Lines Account Manager:

 
• High School Diploma, Minimum 2 years college
• Claims Experience, 1+ years desired
• Adjuster License for the State of North Carolina
• Ability to work independently or in a team environment
• Must have excellent verbal and written communication skills
• Effective organizational skills and accuracy / neatness of work
• Proficient in MS Office (Excel, Word, Outlook)

Other Job Titles considered include Account Executive, Customer Service Representative, CSR, Account Representative, Account Specialist, Account Associate, Client Relationship Manager, Client Engagement Specialist