Workers' Compensation Adjuster

Job Description:
This position involves the administration of lost time workers' compensation claims within a dynamic environment. The successful candidate will conduct thorough investigations of claims, manage medical care and work towards final claim closure. Effective communication with clients, injured workers and provider offices is essential. Responsibilities include identifying subrogation recovery opportunities, adjudicating medical bills, reviewing claims correspondence, ensuring timely indemnity payments, establishing reserves, and managing medical and pharmacy benefits. The role also requires maintaining accurate claim follow-up records, complying with excess reporting policies, ensuring Medicare and EDI compliance, managing allocated loss adjustment expenses, and properly closing claims once all issues are resolved. The position offers a hybrid work environment with a blend of remote and in-office work located in Illinois, with two days in the office weekly. Remote candidates with Iowa experience are encouraged to apply. This is a contract assignment with permanent potential.

Responsibilities:

• Manage and investigate lost time workers' compensation claims effectively to ensure appropriate resolution.

• Communicate clearly and professionally with clients, injured workers, and healthcare providers via oral and written channels.

• Identify subrogation opportunities and handle recoveries through conclusion.

• Review and adjudicate medical bills accurately and promptly.

• Document all claims correspondence to ensure proactive claims management.

• Ensure indemnity payments are timely, accurate and within policy guidelines.

• Estimate and establish reserves on claims for probable final payouts.

• Monitor and manage medical care to guarantee medical appropriateness and reasonableness.

• Maintain a claim follow-up diary system to track ongoing claims activity.

• Comply with excess reporting policies and proper use of pharmacy benefit management tools.

• Utilize in-house telephonic nurse case managers efficiently.

• Ensure all claims adhere to Medicare and EDI compliance standards.

• Manage allocated loss adjustment expenses within budgetary constraints.

• Properly close claims once all issues have been resolved.

Requirements:

• 3+ years recent/consistent indemnity workers’ compensation experience

• Iowa jurisdictional experience

• Strong understanding of medical information and State Workers’ Compensation Acts

• Iowa adjuster license

• Bachelor’s degree and/or a certificate in a related insurance program (preferred) (Experience may be considered in lieu of education)

• Intermediate knowledge of Microsoft Office suite

• Experience with claims management systems

• Ability to multitask independently in a fast-paced environment

• Excellent oral and written communication skills

• Strong attention to detail and a positive team-oriented attitude

• Demonstrated critical thinking and sound judgment in claims management

Pay Range:
The anticipated pay rate for this position is $30.50 per hour. We understand salary is an important factor in a job search and encourage applicants even if their desired compensation falls outside the listed range. Final pay is based on relevant experience, skills and certifications, education, geographic location, market conditions, and internal equity. The organization is committed to discussing how each candidate’s unique qualifications align with this role.

Benefits:

• Medical insurance

• Dental insurance

• Vision insurance

• 401(k) retirement savings plan

Contact:
Kelly Hudak
[email protected]

Equal Opportunity Employer:
The Jacobson Group is committed to fostering an inclusive and equitable workplace that reflects the diverse communities served. We are an Equal Opportunity Employer and do not discriminate against any applicant or employee based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status or any other protected characteristic under applicable law. Diversity of thought, background, and experience is valued as a driver of 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 [email protected] or +1 (800) 466-1578.

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 eligibility criteria, a referral bonus may be awarded.