Job Details

Job Description:
This position involves handling workers' compensation claims, including both medical and indemnity cases. The main requirement for this role is experience in Michigan or Virginia. The role requires thorough investigation to determine claim compensability and causal relationships between injuries and incidents. The adjuster will facilitate employee return-to-work processes, establish appropriate reserves and manage medical bills related to claims. They will also assess potential subrogation recoveries, approve payment plans based on medical support, and close claims upon resolution to meet internal standards and legal requirements. Negotiating settlements with attorneys or injured parties within authority limits and working closely with managers on complex cases are essential components of this role. Maintaining effective relationships with internal and external stakeholders is paramount.

Responsibilities:

• Handle medical and indemnity workers' compensation claims with thorough investigation.

• Determine compensability under workers' compensation laws through detailed claim review.

• Establish causal links between injuries and reported incidents to ensure proper benefit payments.

• Facilitate return-to-work initiatives for injured employees.

• Create timely reserves based on claim profiles and potential recovery amounts.

• Manage and approve medical bills related to non-indemnity and indemnity claims, ensuring they adhere to treatment plans and laws.

• Document claim specifics, including subrogation recovery potential.

• Close and finalize claims following resolution, complying with relevant legislation and internal standards.

• Negotiate settlements within authorized limits with legal representatives or injured parties.

• Collaborate with management on complex or high-reserve claims.

• Build and maintain effective relationships with all stakeholders involved in claims processing.

Requirements:

• 2+ years of workers' compensation claims handling experience with medical and indemnity claims

• MI and/or VA claims handling experience

• Experience handling claims in multiple jurisdictions (preferred)

• Knowledge of workers’ compensation laws and regulations

• Ability to understand medical and legal terminology related to claims

• Bilingual skills (preferred)

• Effective communication skills, both oral and written

• Strong customer service and negotiation abilities

• Capable of managing multiple priorities and meeting deadlines

• Proven problem-solving skills

• Licensed in home state

• Proficiency with computers and standard software; experience with Guidewire (version 8) (preferred)

Pay Range:
The anticipated pay range for this position is $26.00 - $29.00 per hour. We understand salary is an important factor in a job search, and we encourage applying even if desired compensation falls outside the listed range. Final pay is determined based on experience, skills, education, location, market conditions, and internal considerations. We are committed to aligning the right candidate with our needs.

Benefits:

• Medical insurance

• Dental insurance

• Vision insurance

• 401(k) retirement savings plan

Contact:
Rebecca Sami
rsami@jacobsongroup.com

Equal Opportunity Employer:
The Jacobson Group is committed to fostering an inclusive and equitable workplace that reflects the diverse communities we serve. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status or other protected characteristics as defined by law. We believe that diversity of thought, background and experience strengthens our team and drives innovation. All employment decisions are based on qualifications, merit and business needs. If a reasonable accommodation is needed during the application or interview process, please contact us at HR@jacobsongroup.com or +1 (800) 466-1578 to request assistance.

Refer a Colleague:
Do you know someone who would be interested in this project? Submit your referral directly by emailing the Jacobson contact listed above or submitting them through this form. If your referral is hired for a contract assignment and meets all other eligibility criteria, you will receive a referral bonus!