Claims Adjuster I- (Med Only)

Essential Duties and Responsibilities include the following. Other duties may be assigned: Processes claims involving minor injuries and/or pay and close claims. Examines claim forms and other records to determine insurance coverage. Ensures that claim file documentation and reserves are current. Reviews and processes medical bills and other claims-related expenses as appropriate. Pays claimant and providers amounts due. Refers claims that require investigation or have more complex medical issues to supervisor or Claim Representative for investigation and continued billing. Services phone calls and disputes over billing in accordance with company protocols. Assists claims examiners with medical bill processing and filing. Provides general clerical support to claim representatives. Filling of appropriate states forms as required to be in compliance with state reporting requirements. Performs other duties as assigned. Qualifications High school Diploma or equivalent is required 1-2 years prior experience handling worker’s claims/ or an equivalent combination of training, education and experience. Adjuster licensing required; (Multiple jurisdictions will be involved, will be required to have a license that will reciprocate to other states.) Strong organization skills, attention to detail and the ability to multi-task and prioritize work are required. Analytical thinking skills are needed to properly evaluate complex claims A strong attention to detail is necessary as claims adjusters must carefully review documents and policies Good verbal and written communication skills, as well as interpersonal skills are required, experience with negotiations, knowledge of litigation process is preferred. Ability to listen well and negotiate with constituents is needed. Ability to speak a second language is an asset Basic computer skills or the ability to quickly learn new software are required A strong work ethic and time management skills is needed, to efficiently handle a caseload ranging from minor to complex claims Ability to establish and maintain good rapport with clients and claimants is needed. Ability to calculate figures is required Physical Demand While performing the duties of this job, the employee is regularly required to sit; stand; use hands to finger, handle, or feel; and talk or hear. The employee is occasionally required to walk; reach with hands and arms; and stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include close vision. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This description is not meant to be all-inclusive and may be modified from time to time at the discretion of management. Candidates should be comfortable with an on-site presence to support collaboration, team leadership, and cross-functional partnership. Why Join Us: At Acrisure, we’re building more than a business, we’re building a community where people can grow, thrive, and make an impact. Our benefits are designed to support every dimension of your life, from your health and finances to your family and future. Making a lasting impact on the communities it serves, Acrisure has pledged more than $22 million through its partnerships with Corewell Health Helen DeVos Children's Hospital in Grand Rapids, Michigan, UPMC Children's Hospital in Pittsburgh, Pennsylvania and Blythedale Children's Hospital in Valhalla, New York. Employee Benefits We also offer our employees a comprehensive suite of benefits and perks, including: Physical Wellness: Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time. Mental Wellness: Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription. Financial Wellness: Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs. Family Care: Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage. … and so much more! This list is not exhaustive of all available benefits. Eligibility and waiting periods may apply to certain offerings. Benefits may vary based on subsidiary entity and geographic location. Acrisure is an Equal Opportunity Employer. We consider qualified applicants without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Applicants may request reasonable accommodation by contacting [email protected]. Final candidates will be required to complete post-offer verification processes related to the role and in accordance with applicable laws. California Residents: Learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy. Recruitment Fraud: Please visit here to learn more abou

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