Please make sure that you complete all of the questions, and information and sign your application at the end.

 

This is a Remote position or it can be a hybrid position if the adjuster lives in the Philadelphia area.  

 

POSITION SUMMARY:  Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. 

This is a full-time position that requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position.

 

 

DUTIES AND RESPONSIBILITIES:

 

Adjuster will work remotely from home Effectively manages a caseload of 100 to 125 workers’ compensation files, including very complex claims.* Jurisdiction is NY.* Initiates and conducts investigations in a timely manner.* Determines compensability of claims and administers benefits, based upon state law and in accordance with established Company guidelines.* Manages medical treatment and medical billing, authorizing as appropriate.* Refers cases to outside defense counsel.  Directs and manages as appropriate.*  Communicates with claimants, providers, and vendors regarding claims issues.* Computes and sets reserves within Company guidelines.  Limits are larger than those allowed for Claims Examiner I and Claims Examiner II.* Settles and/or finalizes all claims and obtains authority as designated.* Maintains diary system for case review and documents file to reflect the status and work being performed on the file.* Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety-related concerns.* Involves TRISTAR loss control staff when appropriate.* Adheres to all Company policies and procedures.* Conduct file reviews independently.* Other duties as assigned.

* Essential job function.

 

 

EQUIPMENT OPERATED/USED:  Computer, fax machine, copier, printer, and other office equipment.

 

SPECIAL EQUIPMENT OR CLOTHING:  Appropriate business casual office attire