Workers' Comp Team Adjustor II

Job Description: This position manages and maintains control of workers compensation claims for Intermountain Healthcare's self insured / self administered programs. This position facilitates resolution to Intermountain's workers' compensation claims in a teamwork environment by planning, organizing, executing, and managing the claims of Intermountain employees, to include modified duty programs, all aspects of indemnity claims, management of the medical portion of the claims, the supervision of litigation claims. Position Details: This position works as part of a team of workers compensation professionals and is assigned routine to highly complex cases and projects. Incumbent will work Monday-Friday during regular business hours. Although this position will primarily work remotely, 3-6 days per quarter will be spent working on-site. Job Essentials: Serves as a claims adjuster and demonstrates a working knowledge of the laws and the claim resolution environments in Utah (required) and Idaho (if assigned) while maintaining working relationships with these agencies. Performs adjusting functions, including investigation, evaluation and documentation of claims. Responsible for staying current with workers' compensation law and makes independent decisions regarding compensability of individual claims, and for directing legal counsel in litigated cases; making determination and recommendations regarding settlement options. Trains front line team members (Employee Health Nurses, Workers' Compensation Coordinators) on workers' compensation policy and programs. Actively participates in departmental and system-wide meetings and completes assigned training modules in a timely manner. Responsible for evaluating claims and setting appropriate reserves, authorizing medical treatment, and maintaining control of assigned claims. Maintains ongoing knowledge of Intermountain's claim information system. Provides feedback for better and more effective ways of using the system and shares improvement ideas with others. Demonstrates a familiarity with available benefits, such as health plans, payroll, and disability and demonstrates an understanding of how workers compensation benefits interact with other programs to help resolve claimants' concerns, in particular when workers' compensation benefits are denied. Meets with members of these departments as needed to insure proper benefits are being paid. Assigns medical and vocational case managers as needed and works with these vendors to insure positive outcomes. Maintains a productive, effective relationship with the Labor Commission in Utah (required) and the Industrial Commission in Idaho (if assigned) as well as with legal counsel. Effectively performs adjusting functions of assigned claims. Responsible for the evaluation of new claims and timely and accurate documentation of those claims. Sets appropriate reserves on each claim and promptly identifies claims that require reassignment, (lost time claims, compensability questions, significant injury, etc). Continually works to improve customer service by helping to set reasonable expectations for claimants, meeting and exceeding claimant expectations, responding to claimants, employee health, and other Intermountain departments as needed in a timely and professional manner. Maintains control over claims case load. Ensures the timely follow up, review and documentation of individual ongoing claims and is responsible for the authorization of appropriate treatment and prompt payment of medical and other bills. Demonstrates proficiency with Intermountain's information systems in order to process claims and process telephone, e-mail, and calendar-based responsibilities. May perform team lead responsibilities, training and directing the work of others. Note: If employee is hired without a Utah State Insurance Adjusters license, they must receive the license within 18 months. If they do not, they will be removed from the position.

Minimum Qualifications

State of Utah Insurance Adjusters license. Associate's degree and three years of training and experience in workers' compensation claim adjusting. Degree must be obtained through an accredited institution. Education is verified OR five years of training and experience in workers' compensation claim adjusting. Experience working in a role requiring customer service, analysis, and file management skills. Experience in a role working with confidential information of sensitive and personal nature requiring a demonstrated ability to interact in a professional manner when faced with controversial or confrontational settings. Experience using word processing, spreadsheet, database, internet and e-mail, and scheduling applications. Experience in a role requiring effective verbal, written, and interpersonal communication skills. Experience in a role requiring effective verbal, written and interpersonal communication skills. Preferred Qualifications: Experience working with Utah worker's comp claims Physical Requirements: Location: Key Bank Tower Work City: Salt Lake City Work State: Utah Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $21.98 - $33.48 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) . Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice. Apply Job!