Claims Adjuster - Liability

Location: Eden Prairie, Minnesota HYBRID Duration: 2-3 Months

Work location: Tuesday/Wednesday in Office, Monday, Thursday & Friday Remote They are open to fully remote but preference will be local candidates who can come into the office two days a week We'd prefer candidates who have supported retail environmentsPRIMARY PURPOSE: To analyze mid- and higher-level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIESManages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level. Assesses liability and resolves claims within evaluation. Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. Manages subrogation of claims and negotiates settlements. Communicates claim action with claimant and client. Ensures claim files are properly documented and claims coding is correct. May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review. Maintains professional client relationships. Performs other duties as assigned. Supports the organization's quality program(s).Travels as required.

Skills: Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations

Education: Education & Licensing Bachelor's degree from an accredited college or university preferred. Four (4) years of claims management experience or equivalent combination of education and experience required.