CopperPoint Insurance Companies has an exciting opportunity for qualified candidates for a Claims Adjuster-1 - Workers Comp Claims! This role will need to analyze reported medical-only workers’ compensation claims to determine compensability and process medical benefits due to ensure adjudication of claims within company standards and in compliance with regulatory agency requirements. The ideal candidate will possess Arizona jurisdictional technical claims knowledge with additional knowledge of Utah and Colorado jurisdictions.
Job Responsibilities:
- Analyze and investigate medical only claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers’ compensation. Monitor injured workers’ work status to ensure timely conversion to indemnity adjuster. Utilize all available resources as appropriate.
- Pro-actively manage claims in accordance with company standards and statutory requirements. Develop, maintain, and adhere to action plans and reserves while pro-actively managing claims to resolution. Establish and maintain cost drivers and data elements to ensure accurate jurisdictional, NCCI and Medicare reporting. Ensure timely payment of medical benefits. Actively utilize all available cost containment measures and programs (subrogation, medical and non-medical vendors).
- Build and maintain professional customer relationships while communicating claim actions with customer. Identify settlement opportunities. Negotiate settlements with claimants and attorneys. Conducts dispute resolution with claimants and attorneys. Testify at hearings when necessary. Appropriately document communications and claim management activities.
Qualifications/Competencies:
- Basic technical claims knowledge in a workers' compensation claims management environment preferred.
- Ability to communicate in oral and written format.
- Ability to demonstrate strong customer service skills.
- Ability to analyze, interpret, and apply laws, rules and regulations pertaining to workers’ compensation.
- Solid analytical and organizational skills.
- Ability to work in a team environment.
- Working knowledge of Microsoft Office Suites-Word, Excel, Outlook, Teams and general P.C.
- Ensure professional communication with customers through the ability to communicate clearly and concisely, both orally and in writing.
- The knowledge and skill level normally acquired through the completion of a two (2) year undergraduate degree in such areas as business administration or two (2) years’ experience in progressively responsible positions within the insurance or medical field. An associate degree is preferred.
- Full time work experience in workers' compensation claim adjudication or related field, on a year for year basis will substitute for a degree.
- Adjuster License, Associates in Claims (AIC), Workers' Compensation Claims Administration (WCCA), Workers' Compensation Claims Professional (WCCP), Chartered Property & Casualty Underwriter (CPCU) certificates; or other professional designation preferred.
Salary Range:
- $51,400.00 - $66,000.00 USD annually.
- Compensation may vary depending on skills, experience, education, and geographical location.
- In addition to base salary, compensation may include an annual discretionary bonus.
Benefits:
- Employees and their families are eligible to participate in CopperPoint Insurance Companies benefit plans including medical, dental, vision, short-term disability, long-term disability, life insurance, a health savings account, a flexible spending account, and a 401k plan.
- We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee’s annual salary, Short- and Long-term Disability coverage, and Employee Assistance Plan).
Founded in 1925, CopperPoint Insurance Companies is a leading provider of workers’ compensation and commercial insurance solutions. With an expanded Line of insurance products and a growing ten-state footprint in the western United States, CopperPoint embodies stability for policyholders in Alaska, Arizona, California, Colorado, Idaho, Nevada, New Mexico, Oregon, Utah, and Washington. CopperPoint Mutual Insurance Holding Company is the corporate parent of Arizona-based CopperPoint Insurance Companies, Alaska National Insurance Company, and other CopperPoint Insurance Entities.
CopperPoint’s culture of compassion extends to the community through employee volunteerism, corporate matching, Board service, program sponsorships, and in-kind contributions. We empower employees by providing 12 hours of paid volunteer time annually and matching their personal contributions to the charities of their choice up to $500 per year. In 2020, CopperPoint employees reported 3,500 volunteer hours.
CopperPoint offers a competitive compensation package and comprehensive benefits package including major medical, dental, and vision and a wide range of competitive benefits programs, generous matching contributions to your 401(k) plan, generous paid time off, tuition reimbursement, and other education benefits and business casual dress. CopperPoint is an equal employment opportunity employer. All qualified applicants will receive consideration without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital status, ancestry or citizenship status, genetic information, pregnancy status, or any other characteristic protected by state, federal or local law. CopperPoint maintains a drug-free workplace.
