About Us
At Prescient National, we are workers’ compensation specialists focused on providing injured workers with the medical care needed to get them back to their normal daily lives as quickly as possible. Our innovative products and winning strategies in loss reduction help organizations meet the challenges of today, tomorrow, and beyond. You’ll be in an environment where colleagues work collaboratively, share a passion for delivering the best outcomes, and are empowered to share ideas on how we can enhance our services. Build a career in an EPIC atmosphere where teamwork, respect, and achievement live.
About the Job
If you’re passionate about helping people and enjoy a fast-paced environment where no two days are the same, the Prescient National Claims team could be the place for you! As a Lost Time Claims Adjuster, you will be responsible for taking a holistic approach to the injured worker and environment to effectively manage all aspects of a workers compensation file. As a subject matter expert in workers’ compensation claims, your expertise will be relied upon to help injured workers, employers, and internal staff members understand the nuances of the claims environment. Training is provided for continued growth and expanded knowledge and internal movement within the company is embraced, whether it’s trying your hand at a new skill or upward mobility within your area of expertise.
Essential Duties & Responsibilities:
• Review, examine, analyze and investigate workers compensation claims
• Adjust claims according to state specific statutes and regulations
• Communicate with all stakeholder to educate them on the workers compensation process and requirements
• Establish claim reserves
• Coordinate medical treatment for injured workers
• Identify cases with subrogation potential and pursue reimbursement
• Review and interpret medical reports
• Attend claim reviews telephonically and periodically in person
• Audit and approve charges related to a workers compensation claim file
• Manage litigation and settlements
• Maintain appropriate licenses and certifications
• Perform other duties or special projects as assigned
• Participate in departmental, company and team meetings
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Competencies:
• Ability to operate independently and effectively
• Strong interpersonal and organization skills
• Strong problem-solving ability
• Proficient using computer applications including Microsoft Office
• Comfort using internet/online based software
• Detail oriented
• Excellent written and oral communication skills
• Strong negotiation skills
Education/Experience:
• Bachelors degree preferred
• State issued Adjuster’s license with a willingness to gain a license in additional states
• 2+ years of workers compensation insurance experience preferred
• 2 years of insurance experience
Physical Demands:
• Regularly talks throughout the day during both in person conversations and via telephone
• Regularly required to use hands and fingers to handle, feel, or operate objects or tools
• Regularly required to sit for up to 8 or more consecutive hours
• Occasionally lifts up to 10lbs
• Regularly walks through a multi-level office environment
• Regularly types using a computer keyboard for up to 8 hours per day
• Regularly uses a computer mouse for up to 8 hours per day
Work Environment:
While performing the duties of this job the employee regularly works in an office setting.
Schedule/Expected Hours of Work:
The Lost Time Claims Adjuster will be expected to work Full Time. This schedule will include a minimum of a 37.5 hours per week Monday-Friday to fall between the hours of 7am and 6pm.
Other Duties:
This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Equal Opportunity Employer:
Prescient National provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, citizenship, status as a Vietnam-era, special disabled veteran, or other veteran who served on active duty during a war, campaign, or expedition, for which a campaign badge has been authorized, in accordance with applicable federal laws. In addition, Prescient National complies with applicable state and local laws governing nondiscrimination in employment in every location in which Prescient National has employees. This policy applies to all terms and conditions of employment including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfers, leave of absence, compensation and training.
