Medical Only Occupational Accident Claims Adjuster/Work Comp Paralegal or Legal Assistant/Work Comp Adjuster

Blue Star Claims LLC is a Third-Party Administrator specializing in Occupational Accident Claims throughout the United States. This is an excellent opportunity to work in a growing and dynamic work environment. We believe in delivering a high-quality work product to our clients with emphasis on communication and service. We believe in providing an environment where employees enjoy coming to work every day, provide the resources needed to perform their job and assign manageable caseloads. The Occupational Accident Claims Adjuster is responsible for the investigation and adjustment of assigned Occupational Accident claims.

At Blue Star, our expectation is that you:

Investigate and adjust occupational accident claims in accordance with established claims handling procedures using Blue Star guidelines and supervision

Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing occupational accident claims

Authorize and make payment of occupational accident claims utilizing our claim processing protocol in accordance with policy language and within authority levels

Process medically necessary and related bills according to Policy provisions

Make supported and educated claim decisions timely

Forecast potential exposure for reserving claims

Have continued contact with policyholders

Negotiate settlements, if appropriate pursuant to the terms of the policy and within authority levels

Deliver quality claim service to clients and be responsive to client needs

Familiarize yourself with jurisdiction challenges you may face and be mindful of potential exposure

Manage your time efficiently and utilize your attention to detail to every claim you work on

Use established forms and modify letters pursuant to Policy provisions

Review and document medical records outlining treatment plan, restrictions and plan of action

Able to identify mechanism of injury vs symptoms vs non-related conditions

Policy review and administration of benefits pursuant to policy terms

Manage claim to optimal resolution; paying for what we owe with relation to the policies we administer

Establish valuable relationships with our Insureds / Motor Carriers / Brokers / Providers / Preferred Vendors

Work as a team player

Be flexible, use initiative and work with minimum of direct supervision

Use discretion and confidentiality required

Clearly communicate verbally and/or in writing both internally and externally

Be organized, a self-starter and prioritize your duties with attention to detail

Perform other duties as assigned

REQUIREMENTS: 

Highschool diploma or equivalent

At least two years of experience in some manner of medical type claims, claims adjusting, paralegal or legal assistant.

Microsoft Office experience

Completion of our pre-employment assessment via the link below. https://www.ondemandassessment.com/link/index/JB-87PS9BLTA?u=93138

What We Offer:
• Competitive salary and potential performance-based bonuses
• Medical, dental, and vision insurance
• 401(k) with company match
• Paid time off and holidays
• Professional development opportunities
• A supportive, collaborative work environment

CASELOADS OF ADJUSTING PERSONNEL [Average]

Medical Only = up to 150