Claims Adjuster, Senior
Blue KC
**Guided by our core values and commitment to your success, we provide health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some of our offerings include:**
**Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute**
**Annual incentive bonus plan based on company achievement of goals**
**Time away from work including paid holidays, paid time off and volunteer time off**
**Professional development courses, mentorship opportunities, and tuition reimbursement program**
**Paid parental leave and adoption leave with adoption financial assistance**
**Employee discount program**
**Job Description Summary:**
The Senior Workers' Compensation Claims Adjuster is responsible for the initial investigation, analysis of exposure, claim management, and file resolution.
**Job Description**
+ Ability to analyze data and reports for trends, pattern analysis and financial exposure.
+ Knowledge of legal issues and liability related to workers' compensation injuries.
+ High level of knowledge of the worker's compensation industry and claims processes, reporting and regulatory requirements.
+ Excellent research and investigative skills. Ability to clearly express and synthesize case facts, decisions, and rationale.
+ Maintains confidentiality as well as a high degree of professional integrity.
+ Ability to provide a high level of customer service while working in a fast-paced environment.
+ Demonstrated attention to detail with excellent organizational and prioritization skills.
+ Sensitivity to confidential matters is required
+ Works as an effective team member, coordinating with others and contributing to the overall success of the Company
+ Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct
+ Other duties as assigned
**Minimum Qualifications**
+ Bachelor's degree or an equivalent combination of education and experience
+ 5+ years of workers' compensation claims experience
+ Must be proficient in Microsoft Office and bill review software and bill review guidelines
+ Strong verbal and written communication skills
+ Strong decision making and organizational skills
+ Ability to perform processing duties with minimal supervision
+ High degree of professionalism and personal presence
+ Ability to interact effectively and professionally, and provide exceptional service, both internally and externally at all times
+ Must possess and maintain a valid and unrestricted driver's license with proof of insurance
**Blue Cross and Blue Shield of Kansas City is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability.**
**At Blue Cross and Blue Shield of Kansas City (Blue KC), we have long put our members first by developing products and services to meet their needs. From our founding in 1938 to more than 80 years of experience in innovative, patient-centered healthcare coverage, Blue KC continues to keep our members at the center of everything we do. As a market leader, we continue to embrace new ideas to make healthcare more affordable and to improve the customer experience. Come join us!**
**Blue Cross and Blue Shield of Kansas City will extend reasonable accommodations to qualified individuals with disabilities who are otherwise not able to fully utilize electronic and online job application systems. For assistance, please send an email to** Recruitingteam@bluekc.com .
EOE/M/F/Vets/Disability
Affirmative Action Employer
Equal Opportunity Employer
Know Your Rights: Workplace Discrimination is Illegal (https://www.dol.gov/sites/dolgov/files/OFCCP/regs/compliance/posters/pdf/22-088\_EEOC\_KnowYourRights.pdf)
E-Verify Participation
Equal Employment Opportunity/Nondiscrimination/Affirmative Action Policies (https://bluekcmemberportal.azureedge.net/pdf/2024/EEO-Policy-2024.pdf)
IER Right to Work
FMLA (https://www.dol.gov/whd/regs/compliance/posters/fmlaen.pdf)
Pay Transparency
Employee Polygraph Protection Act (https://www.dol.gov/whd/regs/compliance/posters/eppac.pdf)
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