Claims Adjuster

• Liability#26-40124
  $26.25
• 31.25 per hour
  Eden Prairie, MN
  Hybrid
  Job Description
  Our client, a Business Solutions company, is looking for a Claims Adjuster
• Liability for their Eden Prairie, MN/Hybrid location.

Responsibilities:

To analyze mid

• and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.

Assesses liability and resolves claims within evaluation.

Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

Manages subrogation of claims and negotiates settlements.

Communicates claim action with claimant and client.

Ensures claim files are properly documented and claims coding is correct.

May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

Maintains professional client relationships.

Performs other duties as assigned.

Supports the organization's quality program(s).

Requirements:

We'd prefer candidates who have supported retail environments

Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.

Excellent oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Good interpersonal skills

Excellent negotiation skills

Ability to work in a team environment

Ability to meet or exceed Service Expectations

Bachelor's degree from an accredited college or university preferred.

Four (4) years of claims management experience or equivalent combination of education and experience required.