Workers Compensation Claims Adjuster Job Description, Key Duties and Responsibilities

Workers Compensation Claims Adjuster Job Description, Key Duties and Responsibilities

This post provides exhaustive information on the job description of a workers compensation claims adjuster, to help you learn what they do.

It highlights the key tasks, duties, and responsibilities that commonly define the workers compensation claims adjuster work description in most organizations.

This article also presents the major requirements anyone seeking the job of a workers compensation claims adjuster is expected to meet to be hired.

Please, continue reading to improve your knowledge of the workers compensation claims adjuster career:

What Does a Workers Compensation Claims Adjuster Do?

In the process of fulfilling several job responsibilities for their employers, workers are liable to encounter accidents in the course of carrying out these duties, which may eventually lead to injury, and a workman’s compensation claim is usually filed in order to cover medical-related services as a result of the injury caused while on the job.

A workers compensation claims adjuster is responsible for receiving, organizing, and analyzing all files or documents that are related to the worker and the injury in order to make an effective and accurate determination concerning the claim.

He/she abides by the organization or company’s regulations and guidelines in the process of making claim determinations, and these guidelines and job description of the workers compensation claims adjuster may vary depending on the organization in which they work.

In other words, a workers compensation claims adjuster can be described as a qualified individual who is responsible for examining or analyzing workers’ compensation claims.

His/her work description involves collecting compensation claim information, reviewing, and investigating claims, and liaising and working co-operatively with claims administrators; and also processing payments of indemnity.

It also involves carrying out various tasks such as pre-claim duties, which involves contacting the injured worker in order to obtain an account of the happenings surrounding the injury, and also soliciting for records from the medical professionals who are in charge of the patient.

The workers compensation claims adjuster is also responsible for overseeing claim determination once he or she has collected the necessary forms from the employer, the injured worker’s statement, and medical records, then he or she gathers and assesses all the information in order to determine and conclude if the injury was work related or not, and notifies the employer.

A workers compensation claims adjuster also opens a file for the injured employee if he or she determines that the injury was work-related, and will keep receiving all injury-related medical claims on the employee, and then evaluates the claim and forward them to another department for payment, and closes the file when the injured worker is healed.

Individuals seeking to become workers compensation claims adjusters are required to possess or demonstrate several necessary skills or attributes to be suitable for the job.

Some of these skills or attributes include business writing, computer competency, analytical thinking, and ability to efficiently handle financial records, research skills, communication, and time management skills.
In terms of academic qualifications, the individual should possess a Bachelor’s degree in Business or Insurance, or in any related discipline, or a college course work in workers compensation.

Several years of proven work experience or professional training is also demanded by some employers.

Workers Compensation Claims Adjuster Job Description Example/Sample/Template

Workers compensation claims adjuster performs various functions in ensuring accurate determination of workers claims.

The job description of workers compensation claims adjusters usually consists of the following duties, tasks, and responsibilities:

Investigating claims within the given timeframe after receipt of the first report of injury
Contacting the injured employee in order to obtain a detailed account of the injury causes
Requesting records from the medical professionals or personnel who saw the patient
Notifying the employer on his or her claim determination based on findings
Collecting and evaluating claims and sending them to the concerned department for payment
Keeping contact with the injured worker and the medical professionals concerning the status of the injury and plans for treatment
Assessing settlement decisions and opportunities
Being present at mediations, either by phone or in person
Ensuring that injured workers are taken care of appropriately and on time.

Workers Compensation Claims Adjuster Job Description for Resume

If you are making a new resume as someone with working experience of the workers compensation claims adjuster role, you can create a convincing professional experience section for your resume by applying the sample job description provided above.

By highlighting the duties and responsibilities you have performed or are currently performing as a workers compensation claims adjuster in your resume’s professional experience section will make it more impactful in convincing the recruiter that you are a perfect fit for the job.

You can quickly and conveniently create an effective professional experience section for your resume by adopting the workers compensation claims adjuster duties and responsibilities provided in the job description example above.

Workers Compensation Claims Adjuster Requirements – Skills, Abilities, and Knowledge for Career Success

If you are seeking the job of a workers compensation claims adjuster, it is important to know what requirements recruiters commonly expect applicants to meet to be qualified to access the position.

Shown below are major requirements most recruiters commonly set for applicants for the workers compensation claims adjuster job to fulfill to be hired:

Computer proficiency and familiarity with necessary computer tools such as spreadsheets
Good time management skills to investigate and give a report on claims within a given timeframe
Analytical thinking and particular attention to detail which enables to strategically handle investigations and tactically tackle issues
Adequate knowledge of relevant regulations, as a workers compensation claims adjuster is required to abide by various guidelines and procedures
Several years of proven work experience or adequate professional training
A Bachelor’s degree in Business, Insurance, or in any related discipline, or a college course work in workers compensation.

Conclusion

If you are a recruiter or HR manager needing to hire for the workers compensation claims adjuster position, you will need to publish a description of the position to show prospective candidates the duties they will be expected to carry out if hired.

To make a detailed description of the position that can help you attract the best candidates, you can apply the sample workers compensation claims adjuster job description provided on this page.

This post is also helpful to individuals interested in the workers compensation claims adjuster career, to increase their knowledge of what the role does so they can be better prepared for the career.