Claims Adjuster Trainee - Hybrid role
Encova Insurance formerly Motorists Insurance and BrickStreet Insurance has an immediate opening for a claims adjuster trainee.
This position will work predominately in the Charleston, WV office with an anticipated on average three days per week to work from home. The role will report to a Director, Workers' Compensation Claims on the West Virginia Large Accounts team.
We may consider filling this role as a Claims Adjuster with a candidate who has related experience with Workers' Compensation Claims handling.
The Claims Adjuster Trainee is an entry level position designed to prepare the Trainee to be promoted to a Claims Adjuster. This position will receive mentoring and training to prepare the individual to move into the Claims Adjuster role. The trainee's focus will be concentrated on gaining a thorough understanding of Encova's claims process and effectively applying the skills learned.
1. Process a large volume of routine injury claims.
2. Gather facts by conducting a required interview with the employer and other parties as needed.
3. Properly adjudicate claims assigned. Determines eligibility of medical benefits once medical information has been secured.
4. Establish reserves which accurately predict losses reflecting the current known circumstances of the file.
5. Recognize when to transfer claims that might exceed the designated authority level.
6. Present claims and participates in their discussion at team staff meetings.
7. Ability to effectively apply technical knowledge to investigate, evaluate and settle claims.
8. Work collaboratively with injured employee, employer, and health professionals to manage the claim costs, promote quality medical care and timely return to work to achieve optimum cost-effective medical outcomes.
1. Non-essential function: other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
• Bachelor's degree from an accredited college or university preferred.
• Preference may be given to candidates with prior experience in workers' compensation or insurance.
• Must successfully complete the Adjuster's License requirements in applicable states within six months from date of hire.
• Must pass the certification test for the in house Best Practices in Claims Management course within 12 months of employment.
• Strong organizational skills including the demonstrated ability to manage an assigned claims load.
• Strong oral and written communication skills.
• Strong customer service orientation.
• Demonstrated initiative to learn and apply what is learned.
• Demonstrated strong typing skills.
• Strong computer skills, including programs such as Word and Excel and the ability to use the Company's claims management system(s).
• General knowledge of and ability to use basic math.
• Ability to effectively apply established laws, policy, procedures, regulations and guidelines to claims processing.
• Ability to work effectively in a team environment, and effectively collaborate with all stakeholders associated with claims management.
• Ability to apply medical terminology and diagnosis codes, and treatment protocols to claims processing.
• Strong decision-making and objective judgment skills.
• Ability to work effectively in a paperless environment.
This position has been evaluated in accordance with the Americans with Disabilities Act. Encova Insurance makes every effort to reasonably accommodate disabilities to permit performance of the essential functions and candidates who need such accommodation are encouraged to seek it. This description reflects the nature and level of work performed by associates in this position. It is not an all-inclusive inventory of duties, responsibilities and qualifications required. It provides an accurate overview of the work and skills needed to perform this position. Because job content may change from time to time, Encova Insurance reserves the right to add and/or delete functions from this job as it deems necessary for business reasons.
Ready to join our team?
At Encova Insurance, we firmly believe that our associates drive our company's success by delivering unrivaled service to our customers. With success in mind, we make an ongoing effort to provide an environment that offers challenging, stimulating and financially rewarding opportunities.
Join us to discover a work experience where your diverse ideas will be met with enthusiasm - where you can learn and grow to your fullest potential.
What you can expect from us
Join our family of industry leaders, and let us reward you with a competitive salary, bonus and benefits package that includes but is not limited to: a 401(k), wellness programs, bonus incentive plans and flexible schedules, with an early close of the office every Friday. Additionally, Encova aspires to be an outstanding corporate citizen in all the markets we serve; we encourage and support associate participation in community initiatives through our foundations.
Encova Insurance is an EOE/E-Verify employer.
Encova Service CorpCharleston, WV
Finance and Insurance
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