Workers Compensation Adjuster-Full-Time-Days

Facility Cape Fear Valley Medical Center Location Fayetteville, North Carolina Department Risk Management Job Family Clerical Work Shift Days (United States of America) Summary Work in collaboration with Workers Compensation Manager to process workers’ compensation claims for the health system. Position requires high level of communication and analytical skills, particularly in dealing with sensitive and confidential information regarding workers’ compensation claims. Investigate employee injury events, conduct interviews, and file required documentation with governing State agencies, manage and maintain assigned workers' compensation claims, daily diary events and database tracking.

Responsible for approval of all levels of workers' compensation claims. Review and verify payments for services provided and disability amounts in conjunction with the workers' compensation program and individual claims. Major Job Functions The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below.

In addition, specific functions may change from time to time: Investigate and analyze data to determine compensability in accordance with the NC Workers’ Compensation Act Manages assigned workers' compensation claims in a timely manner Attend workers' compensation mediations and NC Industrial Commission hearings as required Independently works within certain limits and authority to actively manage a caseload of complex lost time cases Establish claim reserves, propose and negotiate settlements under the supervision of the Workers’ Compensation Program Manager Approve disability and medical payments and other expenses related to workers' compensation claims Review employee incident report to determine which employee injury/illness incidents meet OSHA recordability criteria and documents individual files in database accordingly Prepares NC Industrial Commission forms and dispatches them to responsible parties Collect, enter, and update information in workers' compensation software database Maintain claims diary and completes diary items in timely manner Review and verify bills for services provided in conjunction with workers' compensation program and individual claims Authorize check requests for workers' compensation benefits, medical payments, case management bills, settlement checks in addition to other miscellaneous expenses Assist with preparation for workers' compensation legal proceedings Keeps current with laws and regulatory requirements related to workers' compensation and OSHA to assist the Health System in maintaining compliance with same Maintain strict confidentiality of all documentation, information, and work-product Other duties as assigned Minimum Qualifications The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job: Education and Formal Training : Associate’s degree in…

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