Workers' Compensation Insurance Claims Adjuster

LOCATION: Raleigh, NC
JOB TYPE: Full Time
DEPARTMENT: Risk Management
OPENING DATE: 2017/04/05
CLOSING DATE: 1970/01/01

JOB TITLE:                             Workers’ Compensation Insurance Claims Adjuster

COMPANY:                              Circle K Stores Inc.

DEPARTMENT:                       Risk Management

FLSA STATUS:                        Exempt

REPORTS TO:                         Risk Manager

LOCATION:                             Raleigh, NC

RELOCATION:                         No

NOTICE NUMBER:                  WCCA-PIE

OPENING DATE:                     04/04/2017

CLOSING DATE:                     Until Filled

 

 

JOB SUMMARY

Under direction, is responsible for communicating with injured workers, store managers, occupational clinics and adjusters. Essential functions include but are not limited to: collaborating with adjusters for authorization of medical treatment when necessary; monitoring adequate reserves on claims; interpreting and explaining workers' compensation laws; coordinating workers’ compensation leaves of absence, OSHA recording and settling claims within authority level.

 

ESSENTIAL JOB FUNCTIONS

·        Conduct office/telephonic investigations on cases assigned by management.

·        Work collaboratively with employer’s third party administrator and insurance carriers.

·        Confirm store location, facts, date and time of loss.

·        Establish related injuries and determine involvement of third party administrator.

·        Collaborate with carrier/TPA regarding reserves, settlements, return to work and communicate with divisions.

·        Assist in the collection of Subrogation claims by recovery of monies, write offs, and court restitutions.

·        Provide information to management by collecting and analyzing data; prepares reports by collecting, formatting, analyzing and summarizing information.

·        Ensure compliance with requirements, policies and regulations by enforcing adherence to corporate systems, policies and procedures; advises management on needed actions.

·        Comply with federal, state and local legal requirements by studying and reviewing existing and new laws; auditing and enforcing adherence to requirements; rendering opinions; advising management on as-needed actions.

·        Electronically track every claim from inception to resolution.

·        Maintain professional and technical knowledge by attending educational workshops; reading professional publications; establishing personal networks; participating in professional societies.

·        Perform other duties as assigned.

·        Telephonic and electronic communications are a major part of the position activity which includes direct communication with management, store personnel, claimants, witnesses, repair facilities, contractors, police and fire departments, state and county fraud personnel, special investigators, attorneys, members of the medical profession, and all other people pertinent to the investigation and processing of claims.

 

REQUIREMENTS

·        Bachelor’s degree in risk management or related field is preferred. 

·        Other combinations of experience and education that meet the minimum requirements may be substituted.

·        Successful demonstrated work experience in insurance claims is required.

·        Must be computer literate in MS Access, Excel and Word.

 

Job duties may change with or without advance notice.

 

TO APPLY FOR THIS POSITION, PLEASE COMPLETE THE ATTACHED INTERNAL POSTING FORM AND SEND RESUME WITH JOB POSTING NOTICE NUMBER TO:

 

Beth Pierce

epierce@circlek.com