Questpro

Claims Consultant - Workers' Compensation

Questpro Louisiana, United States
Questpro

Claims Consultant - Workers' Compensation

Questpro Louisiana, United States
1 week ago 170 applicants

See who Questpro has hired for this role

Position Summary

This position is responsible for managing Louisiana Workers' Compensation Indemnity claims, including the investigation, evaluation, reserving, negotiating, settlement and closure of assigned claims for the I Trust Fund, and TPA clients.

Location: 100% Louisiana Adjusters License required

Strong Tenure & Customer Centric a MUST

Essential Functions & Responsibilities

  • Handle claims consistent with company policies, procedures and standard methodologies and also in accordance with any statutory, regulatory and ethical requirements
  • Ensures the accurate, timely, and appropriate delivery of workers’ compensation benefits in accordance with Louisiana laws
  • Makes prompt contact with policyholders, claimants, witnesses, and other parties involved in the loss to set expectations, develop an action plan, and perform an initial exposure assessment in accordance with company guidelines
  • Determine coverage, liability, and damages, including recorded statements and coordination of field inspections or experts when necessary
  • Plan, recommend, reserve and execute file strategies on assigned claims in a manner consistent with company claim policies and procedure
  • Assures accurate and timely maintenance of reserving and excess reporting in compliance with company guidelines.
  • Ensures regular and timely diary follow-up and brings claims to prompt and appropriate conclusion while keeping our clients informed throughout the life cycle of the claim process
  • Ensures timely payment of benefits and appropriateness of medical treatment
  • Identifies any subrogation potential and liability exposures and consults with the supervisor
  • Maintains up-to-date diary notes and other electronic records that accurately and thoroughly document all file-handling activity
  • May be called upon to perform additional duties as directed
  • Compliance with CMS Section 111 requirements
  • Negotiate with claimants to reach a settlement

Qualifications

  • 3 years or more of workers compensation claim experience.
  • Proficient jurisdictional knowledge of workers’ compensation law
  • Louisiana WC jurisdictional required.
  • Current adjuster licensure or the ability to obtain within 30 days of hire.
  • Excellent computer skills and familiarity with Microsoft Office applications.
  • Ability to communicate effectively with claimants, witnesses, lawyers, insurance company representatives, doctors, and other professionals
  • Customer-centric with exceptional customer service skills
  • Strong problem solving and negotiation skills
  • Ability to work independently

REPORTING RELATIONSHIPS

This position reports to the Vice President of Claims.

  • Seniority level

    Mid-Senior level

  • Employment type

    Full-time

  • Job function

    Finance and Sales

  • Industries

    Insurance

Referrals increase your chances of interviewing at Questpro by 2x

See who you know

Featured Benefits

Inferred from the description for this job

  • Medical insurance
  • Vision insurance
  • Dental insurance
  • 401(k)

Get notified about new Claims Consultant jobs in Louisiana, United States.

Sign in to create job alert

Similar jobs

People also viewed

Similar Searches

Explore collaborative articles

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.

Explore More