CLAIMS ADJUSTER-SENIOR

Recruitment #1505-4292-001

Purpose

Investigate and adjust complicated worker’s compensation claims that involve serious injuries resulting in chronic disabilities and prolonged job displacement. Cases generally have problematic, intricate, and involved issues. Adjust selected litigated claims and negotiate settlements to an established dollar amount. Intervene on complex customer inquiries. Balance high volume work load with the priorities and complexities of chronic disabilities, case management, and job displacement.

Essential Functions

  • Investigate and adjust complicated Worker's Compensation claims maintaining orderly files, with proper and prompt documentation of the events and evidence on file.
  • Negotiate client settlements when needed.
  • Complete worker’s compensation claims adjustments at all levels of complexity to meet the needs of the department.  
  • Respond to all requests from the Wisconsin Division of Worker’s Compensation.
  • Coordinate return to work, end of healing, chronic disability case management and job placement using established resources and protocols.
  • Determine the appropriate Indemnity payment and make on time payments.
  • File required claim reports to the State of Wisconsin within the set time frames.
  • Identify possible subrogation options and protect the City of Milwaukee’s interest.
  • Act as a lead worker to advise and assist other department personnel on case questions and issues.
  • Perform special assignments as designated by the Manager of Worker’s Compensation.

Reasonable accommodations requested by qualified individuals with disabilities will be made in accordance with the Americans with Disabilities Act (ADA) of 1990, as amended by the Americans with Disabilities Act Amendments Act (ADAAA) of 2008.

Minimum Requirements

1.     Bachelor’s degree in Health Science, Health Care Administration, Business Administration, or closely related field from an accredited college or university.  

IMPORTANT NOTE: To receive credit for college, transcripts are required and must be received by the application period closing date. College transcripts should be attached to your online application. Applications without transcripts attached will be considered incomplete and will be rejected. Your transcript must be legible (readable) and include the following information: the university or college name, your name, the degree completed (if applicable) and the date the degree was completed.

2.     Four years of experience as a Claims Adjuster.

Note: Equivalent combinations of education and experience may also be considered.

3.     Valid Driver’s License at time of appointment and throughout employment.

Desirable Qualifications

  • Experience adjusting complex claims at the Senior Adjuster level.
  • License to practice before the Wisconsin Department of Workforce Development Division.

Knowledges, Skills, Abilities & Other Characteristics

  • Knowledge of Wisconsin Worker’s Compensation Law and other related rules and regulations.
  • Knowledge of medical terminology.
  • Knowledge of computer word processing, data base, and presentation software.
  • Skill to give full attention to what other people are saying and actively listening.
  • Skill at negotiating and reconciling differences between opposing parties.
  • Ability to conduct thorough analysis of complex facts and make strategic decisions on complex case files.
  • Ability to combine pieces of information to form general conclusions.
  • Ability to advise and act as team lead on various projects and department functions.
  • Ability to apply general rules to specific problems to produce logical answers.
  • Ability to apply Worker’s Compensation law to everyday claims adjusting work.
  • Ability to utilize computer software to analyze data, create detailed reports, and communication documents.
  • Ability to listen, understand, and gather critical information during case investigations.
  • Ability to work independently to accomplish workload.
  • Ability to communicate information and ideas in an understandable spoken form to customers, coworkers, and supervisor.
  • Ability to communicate information presented in written reports, forms, briefs, and email to customers, coworkers, and supervisor.

Current Salary

SALARY (PR2EX) The current starting salary is $45,306 annually for City of Milwaukee residents.  The non-resident starting salary is $44,195. Appointment above the minimum is possible.

Selection Process

THE SELECTION PROCESS will be job related and will consist of one or more of the following: education and experience evaluation; written, oral, or performance tests, or other assessment methods. The Department of Employee Relations reserves the right to call only the most qualified candidates to oral and performance examinations. Oral examinations may include written exercises. Selection process component weights will be determined by further analysis of the job.  

INITIAL FILING DATE – The examination will be held as soon as practical after September 1, 2015. Receipt of applications may be discontinued at any time after this date without prior notice. However, recruitment may continue until the needs of the City have been met. Qualified applicants will be notified of the date, time, and place of the examination. Unless otherwise required by law, the City of Milwaukee will not provide alternative test administration. The applicant is responsible for attending all phases of the job selection process at the time and place designated by the City of Milwaukee.

NOTE: The City’s residency requirement set forth in City Charter 5-02 is under litigation. Even though the City is legally able to enforce the current residency requirements based on a recent Wisconsin Court of Appeals decision, the City has agreed to continue to suspend enforcement of the ordinance during the time it may take to know whether the Wisconsin Supreme Court will review the case.  Once the Supreme Court refuses review or affirms the Court of Appeals decision, the City intends to fully enforce the ordinance. Consequently, employees who disregard the requirements of the ordinance do so at their own risk. Applicants for City of Milwaukee positions should understand the City’s commitment to its residency requirement. During this period of uncertainty it is important to take that into account when submitting an application and more importantly when deciding to accept an employment offer.  Please contact (414) 286–3751 if you have questions regarding your individual circumstances as part of the application and/or selection process.

Additional Information

APPLICATIONS and further information may be accessed by visiting, http://city.milwaukee.gov/jobs

  • Applications and transcripts should be submitted no later than the deadline listed above.
  • If you would like assistance completing an application, please contact the Department of Employee Relations at (414) 286-3751 or staffinginfo@milwaukee.gov.
  • The Department of Employee Relations is located at City Hall, 200 E. Wells St, Room 706, Milwaukee, WI 53202.