Workers Compensation Claims Adjuster Resume Examples

Workers Compensation Claims Adjusters are mainly responsible for analyzing workers' compensation claims. Typical job duties seen on eligible resume samples are collecting compensation claim information, examining and investigating claims, collaborating with claims administrators, and processing indemnity payments. The ideal candidate for the job should mention the following assets in his or her resume: knowledge of relevant regulations, business writing, computer competences, research skills, analytical thinking, being able to handle financial records, and time management. College coursework in workers' compensation or insurance is required.

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Workers Compensation Claims Adjuster Resume Samples

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Candidate Info

3

years in workforce

3

years at this job

BA

Mass Communication

MA

Master of Arts

Workers Compensation Claims Adjuster

Aggressively investigated workers compensation claims for over 20 clients.

Actively managed over 180 open workers compensation claims, including directing medical treatment and distributing compensation benefits.
Successfully conducted quarterly claims reviews with all clients to keep them abreast of their open claims and claim strategies.
Maintained high level of confidentiality in handling clients' medical claims, including knowledge of HIPPA.

Candidate Info

2

years in workforce

2

years at this job

Marketing

Bank Certified

Workers Compensation Claims Adjuster

Investigated claims to determine compensability; Demonstrate proper claim handling within authority.
Authorized changes in medical providers, medical management, rehabilitative services, vocational training or other procedures or services.
Provided temporary disability payments and monitors case for continuation of benefits; terminates payments when appropriate; Return to work
Conducted negotiations for settlement of claims with claimants and attorneys; insure preparation and filing of necessary legal documents.
Prepared reports on claims and loss statistics and other information as required.

Candidate Info

18

years in workforce

8

years at this job

HS

Millard South

Workers Compensation Claims Adjuster

Managed 100+ cases consisting of medical files and lost time files for the State of Nebraska; Updated and maintained files as appropriate.
Performed claims processing which included investigation of claims, determination of compensability and setting reserves on reported claims, based on the type of injury and treatment recommendations from healthcare providers.
Liaised with healthcare providers to request and review medical treatment notes to adhere to strict recovery timeline and payment timelines to efficiently process claims closures.
Ensured adherence to organizational best practices and client service requirements for completion and claims closures.

Candidate Info

9

years in workforce

1

year at this job

HS

High School Diploma

Workers Compensation Claims Adjuster

Developed interactive Excel spreadsheet for the calculation of disability benefit payments
Coordinate treatment for injured workers between their employers and treating physicians
Adhere to the custom tailored guidelines of each employer regarding coverage and financial reporting
Stay compliant with state legislature enforced through the Industrial Commission of Arizona
Ensure appropriate care is provided to injured workers in order to facilitate timely recovery

Candidate Info

8

years in workforce

4

years at this job

AS

Associate of Science

Professional Property Insurance Adjuster

Workers Compensation Claims Adjuster Assistant

Customer Service for Call Center (In-bound, Out-bound)

Preparation and mailing all Claims Letters for Liability and Worker’s Comp. (Treatment Authorization forms, Benefits packages, Co- pay's, Employee Earnings Reports, Denial's, Travel Reimbursements, Etc.)
Worker’s Comp Medical Bill Indexing to assigned adjusters
Medical billing reviews for Evaluation Of Bills
Contact Medical Providers for Proper Billing (Ub4 or HCFA1500), Medical Records (DWC-25-Treatment status forms, medical notes) and W-9 for payment
Open and process all Workers Comp claims as well as adding new W9 vendors
Run ISO background search on claimants
Report state filing (CMS Reporting)
Coverage confirmation of policy's

Candidate Info

20

years in workforce

4

years at this job

Liberal Arts Program

Workers Compensation Claims Adjuster

Manage and investigate a case load of up to 130 - 150 workers compensation claims.
Provide outstanding service to UFG insured's, claimants and medical partners
Process timely payments and state filings

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