Senior Workers' Comp. Adjuster - New Jersey in Piscataway, New Jersey at Coventry

Coventry
Senior Workers' Comp. Adjuster - New Jersey

US-NJ-Piscataway

Job ID: 24-16934
Type: Regular Full-Time
# of Openings: 1
Category: Insurance & Administration
Mitchell International, Inc.

Overview

The Enlyte Family of Businesses

Mitchell | Genex | Coventry

Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.

Responsibilities

Full-time, remote position

*Must be located in the New Jersey area for onsite meetings*

Independently investigates, evaluates, and resolves assigned New Jersey Workers’ Compensation lost time claims of a more complex or litigated nature in a timely manner in accordance with legal statutes, policy provisions and company guidelines.

• Evaluate claimant eligibility; communicate with attending physician, employer and injured worker.
• Manage high exposure, complex and catastrophic claims.
• Work with both the claimant and their physician to medically manage the claim, from initial medical treatment to reviewing and evaluating ongoing treatment and related information.
• Work directly with employers to facilitate a return to work, either on a full-time or modified duty basis.
• Identify potential for third party recovery, including subrogation, Second Injury Fund or other fund involvement (when applicable) and excess or reinsurance reimbursement.
• Establish compensability status through case investigation and evaluation and application of jurisdictional statutes and laws.
• Where litigation is filed, evaluate exposure and work with defense counsel to establish strong defenses, prepare litigation plan of action, set legal reserve and manage litigation over life of claim.
• Manage diary in accordance with Best Practices and complete tasks to ensure that cases move to the best financial outcome and timely resolution.

Qualifications

Education:

High School diploma required; Associate’s or Bachelor’s degree preferred

Experience:

At least 3-4 years of experience handling New Jersey workers’ compensation claims required; more experience may be required depending upon complexity of claim pending.

Salary: