Claims Adjuster - Remote / Telecommute - Work from home Job at Midwest Family Mutual Insurance, Urbandale, IA

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  • Midwest Family Mutual Insurance
  • Urbandale, IA

Job Description

Job Description

Job Description

Description:

Worker’s Compensation Adjuster

Midwest Family Mutual Insurance Company is seeking a skilled and experienced Worker’s Compensation Claims Adjuster. This is a telework (work-from-home) position, ideal for a motivated professional who can operate independently with minimal supervision.

Applicants must have a minimum 3 years of experience handling Workers' Compensation lost time claims, including litigation. A dedicated home office space and high-speed internet access are required.

Midwest Family currently writes Workers’ Compensation in the following states: AZ, CO, IA, ID, IL, IN, KS, MN, MO, MT, NE, NM, OR, SD, UT, and WI, with recent expansions into KY, MI, and PA. Experience handling claims across multiple jurisdictions is highly preferred. Experience in South Dakota (SD), Arizona (AZ), and Colorado (CO) is a plus.

Essential Job Functions

The Workers’ Compensation Claims Adjuster is responsible for managing claims efficiently while ensuring fair and equitable outcomes and regulatory compliance.

  1. Investigate and Evaluate Claims
  • Confirm coverage and gather relevant facts through interviews and documentation review.
  • Assess eligibility and injury severity to determine compensation according to statute.
  • Review and analyze medical records to support claim decisions.
2. Manage Claims Process
  • Establish and adjust loss reserves appropriately.
  • Negotiate fair and equitable settlements with claimants and their representatives.
  • Maintain clear, accurate documentation of all activities and communications.
  • Monitor vendors and attorneys for performance and cost-effectiveness.
3. Coordinate Medical Care
  • Approve necessary treatments and collaborate with medical providers.
  • Support timely return-to-work initiatives when possible.
4. Legal and Regulatory Compliance
  • Maintain compliance with state Workers’ Compensation laws and internal procedures.
  • Prepare and submit required regulatory state filings and internal processes and procedures.
  • Handle disputes and participate in mediation or hearings as needed to reach fair and equitable resolutions.
5. Financial Oversight
  • Monitor claim costs and ensure timely payment of medical bills and benefits.
  • Pursue subrogation and liens when appropriate.
6. Communication and Service
  • Respond promptly and professionally to all inquiries from stakeholders.
  • Provide ongoing support to injured workers throughout the claims process.
7. Continuous Improvement
  • Maintain compliance through continued training on laws, regulations, and best practices.
  • Identify and implement process improvements to enhance claim outcomes.

Requirements:
  • Ability to work as part of a team.
  • Regular and reliable attendance.
  • Perform other duties as may be assigned.
  • Bachelor’s degree preferred.
  • Minimum 3 years of experience handling Workers' Compensation lost time claims.
  • Dedicated home office space and high-speed internet access.
  • Strong knowledge of Workers' Compensation coverage, legal and medical terminology, and relevant laws.
  • Proven ability to negotiate timely, fair, and equitable settlements.
  • Proficient in Microsoft Office with solid keyboarding skills.
  • Excellent written and verbal communication skills.

Midwest Family Mutual offers a competitive salary and robust benefits package, including 401(K), and a Pension Plan.

Job Tags

Remote job, Home office,

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