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Workers' Compensation Claims Adjuster (Lost Time) - Las Vegas, NV

Company: UnitedHealth Group
Location: Las Vegas
Posted on: June 30, 2024

Job Description:

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life's best work.SM
The Workers' Compensation Claims Adjuster (Lost Time) reviews, analyzes, investigates, makes liability decisions and approves the release of benefit payments up to authorized levels on initial, continued and reopened claims.
Flexible? Friendly? Fast on your feet? That's a great start. Accurate? Accountable? Self Directed? These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and the way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.
This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm PST. It may be necessary, given the business need, to work occasional overtime. Our office is located at 4828 S. Pearl Street, Las Vegas, NV 89121.
We offer weeks of on-the-job training. The hours of training will be aligned with your schedule.
What are the reasons to consider working for UnitedHealth Group? Put it all together - a highly competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success.
Some of our offerings include:


18 days of Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement - up to $5,250 per calendar year for job-related coursework
Adoption Assistance Plan
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) - More information can be downloaded at:

Primary Responsibilities:

Evaluates new and on-going claims to determine liability, giving consideration to contract provisions, disability management duration contract guidelines, medical evidence and vocational evidence.
Investigates questionable claims. - Determines need for additional medical information.
Performs periodic follow-ups to verify continued existence of a disabling condition.
Responds to telephone and written inquiries from claimants, attorneys, physicians and policyholders.
Identifies and forwards claims to specialized internal and external resources in areas such as rehabilitation, investigations, medical exams, settlements and Social Security.
Keeps track of time frames required of mandated correspondence.
This level is responsible for independently reviewing simple to moderately complex claims for adjudication purposes. - Refers more complex claims to higher levels.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:

High School Diploma / GED or equivalent work experience
Must be 18 years of age or older
1+ years of experience adjudicating and processing Workers' Compensation Lost Time claims
Current Nevada Staff Adjuster's or Independent Adjuster License OR previous NV Staff Adjuster's or Independent Adjuster license (within the last 90 days) -
Experience with Microsoft Excel (data entry, sorting/filtering), Microsoft Word (creating documents, templates, lists), and Microsoft Outlook (send/receive email, create tasks, update calendar, set out of office)
Ability to work onsite at 4828 S. Pearl Street, Las Vegas NV 89121
Ability to work full-time between 8:00am - 5:00pm PST including the flexibility to work occasional overtime given the business need

Soft Skills:

Advanced knowledge of fundamental concepts, practices and procedures of case law and state Worker's Compensation laws, subrogation, reserve setting, and litigation management
Ability to multi-task and understand multiple products and multiple levels of benefits within each product
Excellent oral and written communication skills required
Excellent analytical and problem-solving skills required

Nevada Residents Only: The salary range for this is $48,300 - $94,500 per year. Pay is based on several factors including but not limited to -local labor markets, education, work experience, certifications, etc. -UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
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At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #RED

Keywords: UnitedHealth Group, Las Vegas , Workers' Compensation Claims Adjuster (Lost Time) - Las Vegas, NV, Other , Las Vegas, Nevada

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