• Claims Adjuster - Medical Only

    Location US-OH-Richfield
    Posted Date 3 weeks ago(5/2/2018 5:13 PM)
    Job ID
    23571
    # Positions
    1
    Category
    Claims
  • Overview

    National Interstate is a member of Great American Insurance Group. As one of the leading commercial transportation insurers in the nation, we offer risk financing solutions in all 50 states tailored to meet the needs of a wide variety of transportation classes. Our offerings include traditional insurance and innovative alternative risk transfer (ART) programs, including more than a dozen group captive programs catering to niche wheels markets. We are proud to be a multiple Northcoast 99 winner and Cleveland Plain Dealer Top Workplace in Northeast Ohio. It is because of our talented and dedicated team that we are able to live out our company values of integrity, transparency, fairness, accountability, empowerment and collaboration with each transaction we make. If you are ready to join an engaging and driven team such as ours, we would love to hear from you!

    Responsibilities

    • Manage all workers’ compensation, med pay and no-fault claims to effectively and timely provide benefits to an injured worker when due under the requisite state laws
    • Initiate timely contact with the employer, injured worker, medical provider, and any other persons involved
    • Maintain communication with the insured, injured worker, and medical provider throughout the claim
    • Review and remain updated on all current laws and necessary forms
    • Read and understand applicable insurance policy language in order to determine if the alleged injury is covered by the policy
    • Analyze the claim potential and exposure in order to reserve to the maximum probable exposure
    • Refer all medical bills to vendors for bill review, audits and/or peer reviews, and ensure all bills are paid or denied within the allotted time frames for each jurisdiction
    • Assign, monitor, and direct defense counsel in settlement negotiations and claim handling to effectively bring the claim to resolution
    • Maintain an organized file, documented with clear and concise notes of activities and action plans to allow for easy review of the file by supervisors, auditors, etc.
    • Maintain a diary so all claim files are monitored and reviewed on a timely basis
    • Perform other duties as assigned

    Qualifications

    • High School Diploma or General Education Degree
    • One or more years work experience in either the insurance or medical industries
    • Preferred work experience in either workers’ compensation or no-fault claims
    • Preferred 1-2 years of customer service work experience with direct contact with the public
    • Working knowledge of Microsoft Office; experience is strongly preferred in the Word, Excel, and Outlook functions
    • Must have strong analytical and reasoning skills

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