General Dynamics - Bath Iron Works

Sr. Adjuster, Workers' Compensation

Location US-ME-Bath
Req ID
2025-4643
Remaining Positions
1
Post End Date
6/15/2025
Category
Administrative/Clerical
Salary Grade
E
Shift
1st

Job Description

Provide Workers' Compensation (“WC”) claims adjusting in support of BIW's self-insured/self-administered WC program to include, but not limited to:

  • Timely review of new claims for compensability determinations and processing qualified claimants in accordance with strict regulatory agency rules and regulations.
  • Responsible for accurate and timely filing of State and Federally mandated forms in accordance with strict agency rules and regulations.
  • Effectively and efficiently manage -book of claims by reviewing open claims at a regular cadence and documenting medical management with internal and external providers.
  • Provide assistance and guidance to injured employees and providers.
  • Review for reasonableness and approval of  medical invoices in accordance with treatment plans.
  • Identify opportunities for continuous process improvement and work closely with team members toward achieving same.
  • Interact with State and Federal agencies to provide claim data and answer questions.
  • Work closely with Medical Dept., Operations, Human Resources, Labor Relations, and other functional areas to promote early return to work.
  • Evaluate claim exposure, establish case reserves, negotiate and resolve claims.  Work closely with defense counsel on litigated claims to develop litigation plan.  Attend mediation and hearings as necessary.
  • Keep up to date on State and Federal laws as well as Medicare reporting requirements.
  • Participate in the analysis of compliance reports and provide feedback as required.
  • Assist in the process of internal and external financial and claim audits as required.
  • Provide assistance and back up for internal and external reporting, including quarterly CMS (Centers for Medicare & Medicaid Services) reconciliation reports.
  • Other administrative duties as assigned by the Director of Risk Management.

Required/Preferred Education/Training

  • Bachelor's Degree in Business Administration or equivalent combination of education and experience required.

Required/Preferred Experience

  • 5 years of experience in Workers’ Compensation Claims Administration required.
  • Advanced knowledge of MS Office required.
  • Experience in process improvement and/or change management required.
  • Experience with PeopleSoft, WFM, and ATS a plus.
  • Knowledge of Federal and State regulatory compliance requirements a plus.
  • Strong organizational, interpersonal, and communication skills.
  • Self-motivated & team-oriented..
  • High attention to detail required.
  • Able to maintain confidentiality of highly sensitive information.
  • Must be able to manage conflict and have strong decision making skills.
  • Must have adjuster license.

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