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Claims Adjuster in Des Moines, IA at TMC Transportation

Date Posted: 5/15/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    5/15/2019

Job Description

PRIMARY FUNCTION: 

Proactively manages workers compensation claims by determining compensability, administering authorization for treatment and accurately compensates disability benefits in accordance with Iowa Workers Compensation Laws.

 

DUTIES AND RESPONSIBILITIES include the following:

  • Performs intake of the First Report of Injury for injured workers. 
  • Handles medical events for drivers and shop employees.  This includes, but is not limited to: intake, set up, release to full duty, and updating Absentee and Leave of Absence reports.
  • Thoroughly investigates and analyzes loss information to determine compensability.
  • Provides back up to the Work Comp Assistant as needed, including: calculating average weekly wage, handling medical bills, and entering payments.
  • Sets and monitors reserves and payments.  
  • Timely coordinates and authorizes medical treatment and physical therapy for injured workers.
  • Timely offers and coordinates light duty work and travel for injured workers on restricted duty.
  • Upon reaching MMI, when appropriate, determine and issue voluntary PPD payments and work with medical providers to obtain an impairment rating based on the Iowa AMA Guides 5th addition. 
  • Assists in managing subrogation and litigated claims.
  • Other duties as assigned

 

 

Job Requirements

MINIMUM QUALIFICATIONS/EXPERIENCE:

  • Four-year degree with claims experience or related work experience preferred.
  • Strong knowledge of Microsoft Office (Word and Excel) products.  Familiarity with RiskMaster a plus.
  • Ability to multi-task and stay organized, especially when phones are busy.
  • Must be detail oriented and deliver consistent results.
  • Excellent oral and written communication skills.
  • Possess courteous, yet assertive telephone personality.

 

PHYSICAL REQUIREMENTS AND WORK ENVIRONMENT: 

  • The physical requirements and work environment described are representative of those present while performing the essential functions of this job. 
  • Must be able to sit and use telephone and computer, simultaneously, for extended periods of time.
  • Must be able to speak and hear clearly in a high volume telephone environment.