About Acrisure:
Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters, including Insurance, Reinsurance, Cyber Services, Mortgage Origination and more.
Acrisure employs over 17,000 entrepreneurial colleagues in 21 countries and have grown from $38 million to $4.3 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation, client centricity and an indomitable will to win.
Job Summary:
Responsible for managing workers’ compensation claims as assigned by claims supervisor. Investigates claims. Determines the compensability of the claim and extent of liability. Communicates directly with clients, employers, injured workers, physicians, and attorneys to bring claims to a timely conclusion. Must reside in Montana and have a MT license.
Essential Duties and Responsibilities include the following. Other duties may be assigned:
Interviews, telephones, or corresponds with claimant and witnesses; consults police and hospital records.
Claims handling will include litigated claims, subrogation, conditional payments through Medicare and catastrophic claims.
Contacts physicians to obtain medical diagnoses and projected treatment plans.
Monitors medical progress of claimants and coordinates follow-up treatments; reports to employers including any restrictions that may be imposed on claimants’ return to work.
Documents all information from contacts with employers, claimants, physicians, and attorneys into the claims’ management system and ensures that documentation is current.
Calculates and sets reserves through a reserve worksheet including the nature and scope of claims; adjusts reserves to reflect ultimate known exposures.
Issues medical, indemnity, legal and expense payments
Prepares reports for excess carriers and requests reimbursement when needed.
Sets reminders to follow-up on tasks through diaries on the system; reviews and completes diaries daily.
Maintains physical files for claim-related documents such as medical information, legal reports, and other correspondence.
Reviews claims’ submissions for thoroughness and accuracy.
Determines compensability of claims through information gathered and according to workers’ compensation statutes; makes recommendations as to compensability and coverage of claims.
Performs other duties as assigned.
Additional Responsibilities:
Provides guidance and advice to clients on direction of claims after all information has been gathered and analyzed.
Ensures jurisdictional filings are complete and timely.
Obtains pre-certification approval for specific treatments as needed.
Qualifications
High school Diploma or equivalent is required
3+ years prior experience handling worker’s claims/ or an equivalent combination of training, education and experience.
MT State 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.
Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status. California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at www.Acrisure.com/privacy/caapplicant.
To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure’s property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure’s Human Resources Talent Department.
