Claims Adjuster - Workers Compensation

Sunrise System Inc. is currently looking for

• The main function of a Claims Adjuster is to investigate, analyze, and determine the extent to which an insurance company is liable and to determine how much compensation is needed/required.

• Analyze first reports of injury to determine nature of injury and what benefits are owed based on the statute.
• promptly contact insureds, injured workers and medical providers.
• Maintain contact with insured, injured workers or their representative, and providers for the duration of their claim and promptly update all parties as their claim develops.
• Promptly and properly develop the file to provide accurate and timely investigation and loss analysis.
• Maintain an active diary; monitor diary to achieve timely development of file and timely disposition of the claim;
• Recognize and pursue recovery where possible; adhere to all statutory regulations and unfair claim practices act;
• Effectively communicate with all internal and external customers

• Knowledge of insurance contracts, investigative techniques, legal requirements and regulations.
• Ability to work with a wide spectrum of people;
• Develop and maintain strong business relationships with internal and external customers;
• Ability to calculate statutory benefits owed and understand formulaic math
• Excellent written and verbal communication skills;
• Customer service orientation; strong analytical and negotiation skills.

• Bachelor’s degree or 1-3 years’ experience required.