CLAIMS ADJUSTER I-WKRS COMP

POSITION POSTED UNTIL A VIABLE POOL OF CANDIDATES HAS BEEN ESTABLISHED

THIS POSTING IS TO FILL THE CURRENT VACANCY AND TO ESTABLISH AN ELIGIBILITY LIST TO FILL ANY FUTURE VACANCIES THAT MAY OCCUR IN THE NEXT 6 MONTHS

EDUCATION and/or EXPERIENCE

Bachelor's degree in Risk Management Insurance, Business Administration, or a related field plus fundamental knowledge of concepts, practices, and procedures of Risk Management/Workers Compensation. Experience in a Risk Management program can substitute on a year-for-year basis for the required college education. Personal computer skills highly desirable.

INTERVIEW SELECTION PROCESS: The selection process may include one or more components to demonstrate applicants’ knowledge, skills and abilities in job related areas. These may include exercises such as practical demonstrations, written communications, oral interviews and/or competency assessments

SUMMARY

Works closely with Senior Adjuster/Workers' Compensation to determine compensability of claims for medical and indemnity benefits. Prepares written reports, recommends action based on findings. Works with supervisors, employees, and doctors in an effort to return employee to gainful employment where applicable. Prepares and forwards reports to State of Georgia's regulatory board. Carries out major assignments in conducting the operations of the business. Performs work that affects business operations to a substantial degree.

ESSENTIAL DUTIES AND RESPONSIBILITIES

- Under direction of Senior Adjuster- Workers' Compensation, conducts timely investigation of workers' compensation claims.
- Interviews supervisors, employees and witnesses to determine facts surrounding an occurrence.
- Determines proper fee schedules for medical bills as prescribed by the Georgia fee schedule. May calculate weekly indemnity benefit entitlement. Determines medical prescription and mileage expenses to be reimbursed.
- Prepares and forwards forms and reports, of moderate complexity, as required by the Georgia State Board of Workers' Compensation.
- Assures that injured employees are referred to panel doctor. Follows-up with doctor as to the diagnosis, prognosis and treatment and the anticipated date for employee's return to work.
- Follows treatment to ensure employee's return to light duty at the earliest possible date. Works with supervisor/employee to comply with the Americans with Disabilities Act (ADA).
- Assures medical cost containment by 1) obtaining hospital pre-certification, 2) referring to panel doctor, 3) determining fee schedule maintenance for medical invoices.
- Monitors medical only claims closely to determine whether or not claim becomes a compensable lost time claim.
- Carries out major assignments in conducting the operations of the business.
- Performs work that affects business operations to a substantial degree.
- Maintains well-documented claim files.
- Performs other related duties as assigned.

CERTIFICATES, LICENSES, REGISTRATIONS

None required.

Classification: Non-Represented

Number of Openings: 1

Salary Grade – 12

Salary Range: $37,284-$55,927

AMERICANS WITH DISABILITIES ACT

If you are a qualified individual with a disability, you have a right to request that MARTA make reasonable accommodations in order to help you accomplish your work, which must still be performed in all its essential functions.

MARTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state or local protected class.