Senior Workers Compensation Claims Adjuster (department Of Risk Management)

Job Summary
Receive and manage documents and claims forms relative to workers' compensation claims by employees to determine compensability.

Contact claimant and/or their attorney, employer, and claimant's physician to determine the extent of injury and determine compensability.

Verify medical records indicating changes in treatment.

Calculate and authorize the payment of lost wages by monitoring the claimant's time off.

Handle the processing of medical bill payments within the guidelines of the Illinois Workers' Compensation Act, using appropriate cost containment vehicles.

Monitor and maintain claim files until file resolution.

Authorize settlements within office authority.

Minimum Qualifications

• Graduation from an accredited college or university with a Bachelor's Degree
• Four (4) years of administering and adjusting Worker's Compensation claims or directly related experience or
• An equivalent combination of education and/or experience.

Candidates who are contacted will be required to produce original required documents (e.g., current driver's license, diploma, school transcript, certifications, etc.) listed on the Notice of Job Opportunity within five (5) days of being extended an offer, in writing, by the Bureau Chief of BHR (or designee).

Candidates will be notified of how to submit required documents.



*Degrees awarded outside of the United States with the exception of those awarded in one of the United States territories and Canada, must be credentialed by the World Education Services (WES), Educational Credential Evaluators (ECE) or a National Association of Credential Evaluation (NACES) member organization.

KNOWLEDGE, SKILLS, ABILITIES AND OTHER CHARACTERISTICS

Knowledge of the Workers' Compensation Act of the State of Illinois.

Familiarity with the medical, legal, and actuarial elements involved in processing and disposing of medical billing, insurance, Workers' Compensation, or other claims in the State of Illinois.

Skill in using Microsoft Word, Excel, and Access for purposes of manipulating and organizing data.

Ability to communicate effectively in both verbal and written formats and ability to discuss and explain office policy and procedures to individuals and deal effectively with difficult situations involving irate individuals.

Ability to understand the needs, rights and obligations of both the claimant and the employer in workers' compensation claims processes.

Ability to review and utilize medical and legal materials to proactively manage claim files with the goal of timely and cost-effectively resolving claims.

Physical Requirements:
Sedentary Work involves exerting up to 10 pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects.

Sedentary work involves sitting most of the time but may
involve walking or standing for brief periods of time.

The duties listed are not set forth for purposes of limiting the assignment of work.

They are not t...