Compensation Grade:‏‏‎ ‎23

Job Description

As Oregon’s leading workers’ compensation insurer, we work hard to make Oregon the safest place to work. But it takes many people working together to get the job done. 

We lead the industry in quality claims management and drive innovation through exceptional customer care, technology, and a commitment to making a difference. When workers are injured on the job, adjusters determine benefits, manage costs, and help them recover and get back to work. Adjusters also serve as voices of reassurance for workers, employers, and others involved as they navigate the workers’ compensation system.   

We are looking for individuals from a variety of backgrounds, that reside in Oregon and southern Washington, with a strong desire to learn and to serve others. Adjuster experience is not required. Those selected will enter our paid claims adjuster training program, which will take place starting in February 2024. During training, individuals will be given the tools and knowledge needed to be successful in the role and we will help you prepare for the adjuster certification exam. Once you have successfully passed the exam, you will learn and practice key components of managing claims. Training plans and placement may differ based on individual knowledge and experience. We offer flexibility in either a remote or in-office environment, so having a distraction-free area to work and learn is imperative.

This is a fast-paced job, and to do it well, you will need a balance of excellent customer service, a strong work ethic, communication, and analytical skills. Our customers live across all areas of Oregon and adjusters may need to meet face-to-face at times, so the ability and willingness to understand our customer needs is a must. If you’d like a challenging and rewarding career helping Oregon workers and employers, please apply today.

Please note: This position requires that you work from one of SAIF’s offices or remotely from your home in Oregon or Southwest Washington. Flexible workers may be required to travel to one of SAIF’s offices.

Responsibilities

• Attend and acquire knowledge through a formal training program consisting of classroom training and on-the-job training (OJT) experiences to obtain the basic skills and knowledge needed to provide claims management services.  Training will provide information concerning laws, regulations, administrative rules, corporate policies and procedures and claims management systems that affect the processing of workers’ compensation claims.

• Participate in OJT experiences in both compensability and disabling claims functions to apply knowledge to actual case situations. Participate in on-going training opportunities to develop skills in all aspects of claims management, benefits/benefits entitlement, and customer service.

• Develop skills in evaluating claims information to determine compensability, benefit entitlements, claim reserves, and settlement parameters based on claims analysis. 

• Review assigned claims; develops, initiates, and follows through on plans of action. Investigates and obtains medical reports and other information required to make appropriate benefit decisions and manage claims. Ensures timely processing of claim documents based on state regulatory guidelines.

• Analyze claim information, establish reserves up to a $10,000 authority limit for the ultimate probable cost, and document justification.  Refer claims exceeding personal reserving authority to supervisor or designee for approval.  Communicate reserve decisions to all interested parties. Re-evaluate and adjust reserves as claim exposure changes.

• Establish settlement value and settle within authority from supervisor or director.  Negotiate settlements with unrepresented injured workers or legal counsel.

• Authorize and ensure timely and accurate payment of benefits based on applicable statute and administrative rules. 

• Maintain claim records and prepare claim documentation per corporate policies and standards to ensure full compliance with workers’ compensation laws and rules.

• Collaborate with interested parties as needed to coordinate claims management activities and claim resolution.

• Visit and consult with policyholders and agents to discuss claims status and action plans.

• Mitigate claims costs by referring claims with a potential for specialized cost containment services to business partners.

• Manage claims issues until the claims are no longer active. Take action to resolve claims through closure or settlement and/or effects changes in benefit entitlement. Expedites resolution of litigation where possible.

• Comply with the initial examiner certification requirement of successfully passing the final examination and continuing education requirements in accordance with the Oregon Administrative Rules (OARs), Chapter 436, Division 55, to ensure continued certification as a workers’ compensation claims examiner. 

• Explore diverse perspectives and consistently behave sensitively toward differences in cultural norms, expectations, and ways of communicating. Work effectively with others who have different perspectives, backgrounds, and/or work styles.

• Continually sustain the Inclusive Leadership Competencies (ILC) through the Explorer level on an annual basis.

Recommended qualifications

• One or more years of increasingly responsible work experience.

• A bachelor’s degree in the humanities, liberal arts, business, or a related field is preferred. 

• Have or have the ability to obtain certification as a claims examiners in accordance with ORS 656.780 and Chapter 436 – Division 55.

• Other combinations of skills and experience may be considered.

Next step

To receive consideration, please submit your resume with a cover letter by the close of this recruitment. We want your submission to count, so be sure it’s complete.

This recruitment will close on Friday, November 22, 2024.

If a sufficient number of qualified applications are received, this recruitment may close early.

Compensation & Benefits

Typical hiring range:‏‏‎ ‎$66,984‏‏‎ ‎-‏‏‎ ‎$78,805.‏‏‎ ‎The pay range for this position is annually based on a full-time schedule. Actual compensation will be determined using factors such as experience, skills, training, certifications & education. 

SAIF provides a wide range of benefits to employees who work at least 20 hours per week, including health care, retirement savings plans, paid time off, and more. For additional information about SAIF’s total rewards, visit our website at: Total rewards (saif.com)

*Note that eligibility and cost of benefits can vary depending on the number of regularly scheduled hours, and job status such as regular full-time, regular part-time, seasonal, or temporary employment.

Full salary range:‏‏‎‏‏‎ ‎$59,105‏‏‎ ‎-‏‏‎ ‎$98,505

Veterans

We provide preference to qualifying and disabled veterans. For more information please visit saif.com/veterans.

About us

Since 1914, SAIF has been taking care of injured workers, helping people get back to work, and keeping rates low by focusing on workplace safety. Together with our partners, we strive to make Oregon the safest and healthiest place to work.

SAIF is an Equal Opportunity Employer that values diversity in its workplace.