SR Workers Comp Claims Adjuster
Description de l'offre
Claims / Payments
Claims Processing and Administration: Responsible for proactive claim management including directing and/or performing investigation, regulatory compliance, evaluation, negotiation, and disposition of moderate to high exposure claims. Successful accomplishment requires innovative and hands-on claim, medical, and litigation management.
Compliance: Ensure that individual pending is handled within autonomy level, claim handling guidelines, best practices, regulatory requirements, and special claim handling instructions.
Vendor Management: Proactively manage the activities of medical ancillary programs and external counsel, on an individual claim level, to ensure compliance with strategy, budgets, and outcomes.
Customer Service: Effectively build and maintain working relationships with various stakeholders to ensure the proper management and handling of claims. Ability to deliver proactive status reports and meet all special claim handling requirements.
Targets/Metrics: Meet or exceed all individual metric and competencies goals. Assist in achieving department targets and metrics.
Coaching: Support training, developing and coaching of less experienced staff.
Bachelor Degree: Preferably Degree in Economics, Business, Law, or other appropriate discipline
Certification: Completion of professional insurance qualification (e.g. AMIM, CPCU, etc)
Certification: California Workers Comp (Full Indemnity) Certification Required
Minimum 5 to 7 years: Proven track record in handling workers compensation claims, preferably in multiple jurisdictions.
Minimum 5 to 7 years: Demonstrable understanding of applicable statutes, regulations, and case law.
Minimum 3 to 5 years: Proven ability to think critically, anticipate and recognize trends, with the ability to develop solutions in a fast paced environment.
Minimum 3 to 5 years: Proficiency in building and maintaining working relationships in a demanding field.
Ideal experience, though not required: Successful history in coaching and mentoring.
Claims Handling: Expert knowledge of claims handling process from notification to settlement.
Compliance: Expert knowledge of regulatory and Medicare requirements.
Medical and Litigation Management: Thorough understanding of legal processes and procedures, litigation management, and litigation avoidance techniques. Thorough understanding medical trends, terminology, and cost containment programs.
Systems: Working knowledge of or ability to learn various claim operating systems, Microsoft Office applications, and specific regulatory systems.
Advanced: Analytical Skills: Effective analytical and interpretive skills.
Advanced: Negotiation and Conflict Management: Ability to negotiate best position for AGCS and the client, often in contentious situations, managing conflicting priorities of involved parties.
Communication and Presentation: Ability to express ideas and messages clearly, both written and verbally.
Customer Service: Ability to establish and maintain effective working relationships with management, underwriting, agents/brokers, and policy holders.
This opportunity can be based in the O'Fallon, Burbank or Petaluma AGCS Field Offices.
Allianz is the home for those who dare – a supportive place where you can take the initiative to grow and to actively strengthen our global leadership position. By truly caring about people – both its 88 million private and corporate customers and more than 140,000 employees – Allianz fosters a culture where its employees are empowered to collaborate, perform, embrace trends and challenge the industry. Our main ambition is to be our customers' trusted partner, instilling them with the confidence to grow. If you dare, join us at Allianz Group.
Allianz is an equal opportunity employer. Everybody is welcome, regardless of other characteristics such as gender, age, origin, nationality, race or ethnicity, religion, disability, or sexual orientation.
Allianz Global Corporate & Specialty (AGCS) is the Allianz Group's dedicated carrier for corporate and specialty insurance business. AGCS provides insurance and risk consultancy across the whole spectrum of specialty, alternative risk transfer and corporate business: Marine, Aviation (incl. Space), Energy, Engineering, Entertainment, Financial Lines (incl. D&O), Liability, Mid-Corporate and Property insurance (incl. International Insurance Programs).
Worldwide, AGCS operates in 30 countries with own units and in over 210 countries and territories through the Allianz Group network and partners. In 2016, it employed around 5,000 people and provided insurance solutions to more than three quarters of the 'Fortune Global 500' companies, writing a total of €7.6 billion gross premium worldwide.
AGCS SE is rated AA by Standard & Poor's and A+ by A.M. Best.
More information about careers at Allianz Global Corporate Specialty can be found at www.agcs.allianz.com/careers
À propos de Allianz
Allianz est l’une des premières compagnies mondiales d’assurance, avec un chiffre d’affaires qui s’élevait à plus de 100 milliards d’euros dans le monde en 2012. Présent dans plus de 70 pays, dans lesquels il compte 144 000 collaborateurs, Allianz est spécialisé dans plusieurs métiers : l’assurance pour les particuliers, professionnels, entreprises et collectivités, et la gestion du patrimoine. En France, le groupe compte plus de 5 millions de clients et 2500 points de vente.
Allianz organise régulièrement des campagnes de recrutement pour ses alternants et stagiaires. Son objectif est également de recruter 30 % de jeunes diplômés parmi ses embauches en CDI, parmi lesquels 30 % ont effectué un stage ou une alternance au sein du groupe. Allianz propose des offres d’emploi au sein de différents métiers : l’assurance, le support, le management et pilotage, le digital, la vente et le marketing.