Claims Apprentice at PMA Companies in Pittsburgh, Pennsylvania

Posted in Other 14 days ago.





Job Description:

The Claims Apprentice Program is an exciting opportunity for recent college graduates interested in a career as a Claims Adjuster in the Property & Casualty insurance industry. As a Claims Apprentice, you will be trained by PMA's team of claims experts and leaders. Over the course of the nine-month program, you will develop your skills and knowledge in the area of workers' compensation and/or property and liability as well as assume a caseload of claims of increasing complexity.


Job Responsibilities:


  • Promptly investigate assigned claims. Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable).

  • Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.

  • Within granted authority, establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure. Negotiate claims settlements within granted authority.

  • Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition.

  • Work collaboratively with PMA nurse professionals to develop and execute return to work strategies.

  • Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced.

  • Communicate effectively with internal and external parties on a wide variety of claims and account issues.

  • Authorize treatment based on the practiced protocols established by statute or the PMA Managed Care department.

  • Assist PMA clients by suggesting panel provider information in accordance with applicable state statutes.

  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.






Requirements:



  • Bachelor's degree.

  • 1-3 years of work and/or volunteer experience in a service-oriented setting.

  • Leadership ability as demonstrated through participation in extra-curricular activities.

  • Strong organizational and multi-tasking skills.

  • Ability to work independently.

  • Strong critical thinking skills that demonstrate analysis, judgment and sound decision making.

  • Excellent verbal and written communication skills.

  • Excellent customer service skills.


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