Claims Specialist

• Investigate and adjust workers’ compensation claims according to company standards and established claim handling procedures
• Evaluate medical, legal, and related claim documentation to support timely and accurate claim decisions
• Authorize and process claim payments within applicable authority and regulatory requirements
• Negotiate settlements with claimants, attorneys, and other stakeholders
• Coordinate with defense counsel and external service providers to support effective claim resolution
• Prepare claim reports, reserve recommendations, and documentation to maintain claim accuracy and compliance
• Manage claim activities across multiple accounts and industries while meeting service commitments
• Deliver responsive, professional service to clients, injured workers, and business partners

Workers’ Compensation Claims Adjuster II

• Analyze liability claims on behalf of clients to determine benefits due
• Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements
• Analyze and process claims through action plans to reach appropriate and timely resolution
• Investigate claims and gather information to determine exposure
• Negotiate claim settlements within designated authority
• Communicate claim activity and processing with claimants and clients
• Report claims to excess carriers
• Respond to requests for direction professionally and in a timely manner

Claims Adjuster – Liability, GL, BI, PD

• Investigate and resolve insurance claims with a focus on accuracy, efficiency, and fair resolution
• Independently manage caseloads and negotiate settlements
• Verify coverage by reviewing policies and interpreting policy terms, conditions, and language
• Evaluate liability using recorded statements, police reports, and other pertinent evidence
• Negotiate or deny liability based on investigation outcomes
• Evaluate physical damage and bodily injury claims using estimates, photos, appraisals, medical reports, medical bills, and other evidence
• Coordinate with medical providers, repair shops, and contractors to facilitate necessary services
• Set appropriate claim reserves based on ongoing liability evaluations
• Negotiate bodily injury settlements with policyholders, claimants, attorneys, and other insurance carriers
• Ensure claims are paid promptly within authorized limits
• Document decisions, communications, and activities throughout the claims process
• Provide empathetic customer service, explain the claims process, communicate updates and decisions, and explain decision rationale
• Ensure compliance with industry regulations, legal requirements, and internal policies

Claims Specialist jobs in Iowa

Workers’ Compensation Claims Adjuster II

Claims Adjuster – Liability, GL, BI, PD

Claims Representative – Liability