Workers' Compensation Claims Adjuster Trainee

ID 
2013-1147
Job Location 
US-OH-Richfield
More information about this job:
Overview:

Established in 1989, National Interstate is one of the leading specialty property and casualty insurance companies in the country.  We offer more than 30 different insurance products, including traditional insurance, innovative alternative risk transfer (ART) programs for commercial companies and insurance for specialty vehicle owners.  We are able to provide innovative and customized insurance products because of the talented and dedicated members of our team.  National Interstate employs over 500 employees in offices in Northeast Ohio, PA, HI, and MO. 

Responsibilities:

Summary:

Investigate and handle Workers Compensation and PIP/Med Pay claims involving first party injury claimants utilizing state specific guidelines.  Foster growth of our claims professionals while completing an in house training program.  This includes developing a fundamental understanding of the claims environment while providing quality customer service.

 

Main responsibilities:

  • Initiate the investigation of new claims, make compensability decisions, and evaluate and negotiate settlements of med only, lost time, PIP/Med Pay claims, as appropriate.
  • Manage and oversee the work of outside adjusters, nurse case managers, and experts.
  • Develop a basic understanding of medical principles.
  • Recognize state specific laws and claims regulations throughout the United States to insure proper compliance in claims investigation, including sending and securing proper documentation.
  • Summarize and make recommendations for the disposition of claims in excess of the individual settlement authority.
  • Audit fees of independent adjusters, appraisers, and other vendors in order to properly manage and pay expense invoices.  Consult with the supervisor for guidance on the use of outside experts.
  • Document claim file notes clearly with all communications and activities that occur during the handling of the claim using factual and objective information.
  • Respond to time sensitive materials, including but not limited to hearings and departments of insurance complaints.
  • Manage a diary system to systematically review and resolve claims within the specified state guidelines.
  • Maintain state license(s) by completing continuing education coursework and/or work towards a claims designation.
  • Complete pictorials within the designated timeframe.
  • Other duties as assigned.

 

Qualifications:
  • Bachelor's degree required and customer service experience preferred.
  • Claims designation and/or state licensing a plus.
  • Ability to read and interpret insurance policies, state laws and regulations.
  • Ability to speak effectively before vendors, customers, claimants, attorneys, and company management.  
  • Must be able to interpret policies, perform analytical research and investigations, and make sound judgments from data and records collected.
  • May require some work outside of normal business hours to meet deadlines and/or to meet personal performance objectives.
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