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UnitedHealth Group - Charleston, WV
posted about 1 month ago
Full-time - Entry Level
Onsite - Charleston, WV
Insurance Carriers and Related Activities
About the position
The Claims Adjuster position at UMR involves managing self-insured claims for designated client accounts, ensuring proper evaluation and resolution of claims while adhering to state workers' compensation laws. The role requires strong analytical skills, effective communication, and the ability to work collaboratively with clients and legal counsel. This full-time position offers opportunities for career development within a rapidly growing organization.
Responsibilities
- Review new Self-Insured claims on designated client accounts and determine compensability.
- Establish reserves, review for subrogation, and authorize medical treatment.
- Handle all aspects of Self-Insured injury claims.
- Recommend high-level claim strategies to clients.
- Refer claims to defense counsel and manage litigation processes.
- Attend and facilitate client meetings and claim reviews.
- Review claims status and action plans using advanced problem resolution skills.
- Provide status reports to clients.
- Investigate, evaluate, and negotiate resolution/settlement of claims in accordance with state laws.
- Plan, prioritize, and track work status effectively.
- Assign tasks to medical bill processors and other team members.
- Develop timelines and milestones for claims processing.
Requirements
- High school diploma/GED or equivalent work experience.
- Must be 18 years of age or older.
- 2+ years of experience in a related environment (office, administrative, clerical, customer service).
- Experience with Microsoft Excel, Word, and Outlook.
- Familiarity with computer and Windows PC applications.
- Willingness to obtain adjuster license in required states within 6 months.
- Must reside within a commutable distance to the office.
Nice-to-haves
- 1+ years of claims adjuster experience.
Benefits
- Opportunities for career development and advancement.
- Supportive work environment that encourages performance and recognition.
