7 Ways to Get a Job Handling Claims or Advance in the Job You Have

 
So you want to pursue a career in the insurance industry? It is a good choice; the insurance world is essentially recession-proof and in times of poor economic performance, the insurance industry is booming! Or, maybe you are looking for a promotion or a little more security in the job you have.
 
 
When you think about it, everyone needs insurance, whether it is personal lines of insurance (auto, house, boat, etc.) or commercial lines (employer, work comp, premises, liability, etc.) everyone needs an insurance policy of some sort to protect their investments or their businesses.(WCxKit)
 
 
Requirements for getting into the claims adjusting field vary by carrier, but below we discuss seven items that are standard requirements. Already working in claims? Try to check off as many of these attributes as you can.
 
 
7 Must-Haves to Get (or Keep) a Job in the Insurance Industry

1.     
You usually need a college degree:
There was a time that a high school diploma would get you a job in claims. But times have changed, and to be considered for a career in claims you must have a bachelor’s degree in an insurance-related field, such as accounting, finance, economics, law enforcement, or human resources. If you can manage going back to school (on-line degrees are becoming easier and more legitimate), consider bumping up your education.
 
 
That is not to say if you have a degree in mathematics that you cannot get in, but if your studies included one of the disciplines listed above you have a better chance. Although some would argue with me, more often than not, carriers want someone who has zero experience in the industry. This way, people do not bring in bad habits learned at other carriers. Every carrier has a specific way of handling claims, and if they can train you from the ground up, it is seen as an asset, depending on the job position.
 
 
2.      You have to have a good credit score:
Since you would be a fiduciary agent for your new employer, you need to carry a decent credit score. This will show your employer you take care of financial obligations in your personal life. Remember, you may be responsible for tens of thousands of dollars that are not yours. You have to represent the company at all times, whether you are working in the office or you are down at the courthouse trying to negotiate a file toward settlement.
 
 
The carrier will view your credit score as the way you handle your own financial obligations, and if you can show that you are responsible in your personal life, chances are you will act the same with their money as well. Already have a job? Remember your credit report may be just a Google search away from your boss’s fingertips – stay as clean as you can.
 
 
3.      It helps to have law enforcement background:
Having a background as a police officer or some other work experience in law enforcement will help put you ahead of other applicants. These fields carry a certain degree of responsibility and investigational skills that transfer over to the insurance field.
 
 
Since you will be investigating every claim for compensability, being very experienced at doing detailed investigations is a great asset. Every claim you handle will need some degree of investigation. It also means you complete a thorough and detailed investigation. Investigation is probably the most important task because results deem if a claim will be paid. A particular claim may start as nothing major, but every claim has a chance to morph into a monster potentially worth hundreds of thousands of dollars. Being comfortable doing detailed investigations is something every carrier is looking for.
 
 
4.      It helps to have a legal background:
Obviously work in claims carries the responsibility to read and interpret the legal system, sometimes in many jurisdictions at the same time. Having a law degree and/or prior work involving the legal system is another great asset you can have that will carry into the insurance field. Every claim will need to be deemed compensable or not, and the basis of your decision will depend on your investigation and how the injury or damage relates to legal statutes within the jurisdiction you are handling.
 
 
5.      You should be organized and detailed:
Being a claims adjuster requires you to handle several issues at the same time. Every day you would have a list of things to accomplish on certain files. Additionally, you have to accomplish tasks in order of importance. I do not see many adjusters in the business who are not organized or have some system in place to handle files. A typical adjuster has about 150 files, sometimes more, and all of those files are at different stages in the claim. If you are organized and detailed, you will survive. If you are unorganized and do not have a system in place, you will drown in a sea of paperwork, phone calls, and emails.
 
 
6.      You must pursue an insurance or adjuster’s license
All carriers require you to either be licensed or to secure a claims adjuster license within the first 90 days of hire. This is a comprehensive, state-administered, pass-or-fail test. The test can be quite daunting; especially to those with no experience, but with some studying and hard work it is achievable. Carriers provide you with study materials, and will give you a few tries. Securing your license is a must. If you do not already have one you should plan on getting one as soon as possible as part of your new-hire process.
 
 
7.      You have to know or pass a HIPAA compliance test
HIPPA stands for the “Health Insurance Portability and Accountability Act of 1996.” Since you will be dealing with medical records, social security numbers, and other personal identifiers, every carrier requires you to pass a HIPPA compliance test. You have to be able to be trusted with your claimants’ personal information. Handling and disposal of those records is very important. Carriers can face fines and penalties if they are caught violating the HIPPA terms, and they are constantly educating you in proper ways to handle personal information. You should be aware of HIPAA, and the overall guidelines contained within before starting work with a carrier.(WCxKit)
 
 
In conclusion, a career in the insurance world is very rewarding, and job security within this industry is like no other. With some hard work, organization, and studying there is no doubt you will succeed.

Author Rebecca Shafer
, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
 
 
 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

Know Four Types of Workers Compensation Adjusters

Carriers have classes of adjusters usually correlating with each adjuster’s amount of experience. Although class names vary, they are usually divided into medical-only, lost time/Indemnity, litigation, and catastrophic adjusters.
 
 
1 – Medical-only adjusters
Medical-only adjusters, an entry level position, are trainees with little to no experience. They handle minor medical claims involving simple lacerations and minor strains/sprains not involving any lost wages or complicated medical injuries/conditions. When an employee has a few clinic visits the employer sends the claim in with the bills and the adjuster sets up the claim, processes the bills, and closes the claim.
 
 
Medical-only adjusters conduct the initial interview with the employer and the employee. The interview itself does not go into great detail or investigation as the injuries are usually minor with uncomplicated outcomes.
 
 
When claims are time limited (60 to 90 days) and the claimant continues to receive medical treatment, the claim may be transferred to the lost time adjuster. Look upon extended claims as a “red flag” indicating a possible reason the employee is not returning to transitional or full duty work. Sometimes Lost Time adjusters handle medical-only claims, especially when they are "enhanced situations" where there is a complexity such as ongoing medical expenses.
 
 
2 – Lost time/indemnity adjuster
Lost-time/indemnity adjusters are more experienced, with knowledge of local legal statutes and a high degree of medical training in handling occupational claims. Their expertise is with claims running past 90 days involving more severe injuries such as a complicated lacerations, level 2/3 sprain/strains, surgical repairs, or pending surgeries. When employers question claim compensability, the claim is immediately assigned to the lost time/indemnity adjuster.
 
 
The adjuster takes a recorded, detailed statement, and interviews the employee and any witnesses to the injury. Sometimes a visit to the premises is needed to investigate certain claims. (WCxKit)
 
 
Claims are handled until the claimant is either released from care, or the claim goes into dispute. These claims may remain with the adjuster for months or even years.
 
 
3 – Litigation adjuster
Litigation adjusters handle claims involving lawsuits. These adjusters share the same level of experience as the lost-time adjuster. However, they have advanced training in legal issues and in investigating the compensability of occupational claims.
 
 
When a compensable claim is disputed, and the claimant retains counsel and files a Notice for a Hearing, the claim goes from the lost-time adjuster to the litigation adjuster. The litigation adjuster works with in-house or outside counsel gathering details on the injury, and appears for hearings and mediations to quickly resolve the claim at minimum legal expense.
 
 
The litigation adjuster usually cannot speak directly to a claimant due to the retainer of plaintiff counsel. Therefore, the adjuster relies heavily on the employer’s investigation and facts of injury, if known, and works on gathering medical records, witness statements, police records, prior plaintiff litigation history, and any other facts about the claim, gathering evidence to use in defending the claim. The claim is handled through settlement or trial and then closed.
 
 
4 – Catastrophic adjuster
This level of adjuster is the most complex, handling very difficult claims, usually ones where the claimant has a severe injury requiring multiple surgeries, amputations, loss of sight, hearing loss, or internal medical issues such as asbestosis or chronic joint degeneration due to occupational exposure, etc. Employers hope for few of these type claims, but it is a bullet that cannot be dodged forever.
 
 
General/catastrophic adjusters have many years of experience in the Insurance industry, combined with advanced medical and litigation training and experience. They also have advanced claim investigation training, and may possess a law degree or are licensed attorneys. They delve very deeply into the complexities of the claim in an attempt to resolve all issues of medical treatment expense and ongoing incurred wage loss. Sometimes they suggest large settlements or annuities to avoid ongoing claim costs for life or advanced vocational retraining, a very expensive proposition lacking a guaranteed positive outcome.
 
 
These types of serious claims may last for years, and sometimes involve vocational retraining and job placement for the claimant when the sustained injury is so severe return to work is impossible.
 
 
Summary
Carriers typically have four levels of adjusters, ranging from the newly appointed claims trainee to the severe/catastrophic claims veteran. The important thing for the employer to know is in the event of a severe claim, your carrier retains the proper adjuster to handle all aspects of the claim in order to protect your best interests.

Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.

 
 
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

Professional Development Resource

Learn How to Reduce Workers Comp Costs 20% to 50%"Workers Compensation Management Program: Reduce Costs 20% to 50%"
Lower your workers compensation expense by using the
guidebook from Advisen and the Workers Comp Resource Center.
Perfect for promotional distribution by brokers and agents!
Learn More

Please don't print this Website

Unnecessary printing not only means unnecessary cost of paper and inks, but also avoidable environmental impact on producing and shipping these supplies. Reducing printing can make a small but a significant impact.

Instead use the PDF download option, provided on the page you tried to print.

Powered by "Unprintable Blog" for Wordpress - www.greencp.de