Sr. Adjuster-Workers Comp Claims at CopperPoint Insurance Companies

United States

<p><span style="color: #000000;">CopperPoint has an exciting opportunity for a fully remote Claims Adjuster Senior, Indemnity. The ideal candidate must possess Texas jurisdiction technical claims knowledge and reside in the state of Texas.&nbsp; Additional knowledge of Oklahoma jurisdiction, as well as surrounding Southwest states is highly preferred.&nbsp; The Claims Adjuster Senior, Indemnity is responsible for analyzing time loss workers&rsquo; compensation claims to determine compensability. They will also adjudicate claims to ensure timely payment of indemnity and medical benefits due within company standards and in compliance with regulatory requirements, as well as establish and maintain action plans and reserves to ensure proactive, cost-effective claims management.</span></p> <p>&nbsp;</p> <p><span style="color: #000000;"><strong>Job Responsibilities:</strong></span></p> <ul> <li><span style="color: #000000;">Analyze and investigate indemnity claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers&rsquo; compensation. Utilize all available resources as appropriate.&nbsp;</span></li> <li><span style="color: #000000;">Build and maintain professional relationships with injured workers, policy holders, brokers and agents through proactive claim management and timely communications.&nbsp;</span></li> <li><span style="color: #000000;">Appropriately document communications and claim management activities.</span></li> <li><span style="color: #000000;">Develop, maintain and adhere to action plans and reserves on indemnity claims while proactively managing claims to resolution.</span></li> <li><span style="color: #000000;">Establish and maintain cost drivers and data elements to ensure accurate NCCI and Medicare reporting.</span></li> <li><span style="color: #000000;">Proactively manage claims in accordance with company standards and statutory requirements.&nbsp;</span></li> <li><span style="color: #000000;">Ensure timely payment of indemnity and medical benefits. Actively utilize all available cost containment measures and programs.</span></li> <li><span style="color: #000000;">Identify settlement opportunities.</span></li> <li><span style="color: #000000;">Negotiate settlements with claimants and attorneys.</span></li> <li><span style="color: #000000;">Conducts dispute resolution with claimants and attorneys.</span></li> <li><span style="color: #000000;">Testify at hearings when necessary.</span></li> </ul> <p>&nbsp;</p> <p><span style="color: #000000;"><strong>Qualifications/Competencies:</strong></span></p> <ul></ul> <ul> <li><span style="color: #000000;">Excellent customer service skills to include initiative, mature judgement and discretion.</span></li> <li><span style="color: #000000;">Bachelor's degree (B. S. or B.A.) in business administration, communications, or a related field from an accredited four-year college or university is preferred.&nbsp;</span></li> <li><span style="color: #000000;">This is not an entry level position- A minimum of 3 years of direct handling of Texas workers&rsquo; compensation claims is required</span></li> <li><span style="color: #000000;">Experience in one or more of the other states in our region is preferred (AZ, UT, NV, NM, OK, MO, KS, FL, GA, NC, SC)</span></li> <li><span style="color: #000000;">Texas Adjusters license is required. &nbsp;</span></li> <li><span style="color: #000000;">Bilingual in Spanish preferred.</span></li> <li><span style="color: #000000;">Strong technical claims knowledge with prior successful experience in a workers' compensation as well as other commercial lines claims management environment.</span></li> <li><span style="color: #000000;">Knowledge of Department of Insurance (DOI), NCCI, Department of Labor and Employment (CDLE) rules and regulations.</span></li> <li><span style="color: #000000;">Ability to analyze, interpret and apply laws, rules and regulations pertaining to workers&rsquo; compensation.</span></li> <li><span style="color: #000000;">Ability to stay current with changes to statutory, industry rules and regulations as well as company policies and procedures which may impact claims management.</span></li> <li><span style="color: #000000;">Ability to set priorities, manage time, organize work and meet deadlines.</span></li> </ul> <p>&nbsp;</p> <p><span style="color: #000000;"><strong>Benefits:</strong></span></p> <ul> <li><span style="color: #000000;">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.</span></li> <li><span style="color: #000000;">We provide some benefits at no cost to the employee (Basic Life Insurance and AD&amp;D at two times an employee&rsquo;s annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan).</span></li> <li><span style="color: #000000;">Employees will accrue 0.0769 hours of Paid Time Off (PTO) per paid hour, which may total 20 days a year. In addition, employees will also receive 10 paid holidays throughout the calendar year.</span></li> </ul> <p>&nbsp;</p> <p><span style="color: #000000;">Founded in 1925, CopperPoint Insurance Companies is a leading provider of workers&rsquo; 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.</span></p> <p><span style="color: #000000;">CopperPoint&rsquo;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.</span></p> <p><span style="color: #000000;">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.</span></p> <p><span style="color: #000000;"><strong>#LI-REMOTE</strong></span></p>