W.C. Claims Representative

Responsibilities

• Understand and consistently apply customer service concepts and requirements.
• Conduct thorough initial investigations to determine coverage, compensability, subrogation, and fraud.
• Read and evaluate medical reports to determine extent of injury and treatment plans; recognize, research, and analyze complex medical issues.
• Implement proactive direction and control with timely intervention and action planning.
• Apply basic reserving concepts and adhere to company reserving guidelines.
• Utilize managed care cost‑containment programs, services, and vendors to control costs.
• Recognize and aggressively pursue all potential subrogation recovery opportunities.
• Apply legal and statutory concepts of the applicable jurisdiction.
• Provide consistent, meaningful file documentation using the queue and calendar system.
• Demonstrate superior communication skills in all aspects of the position, emphasizing meaningful correspondence and effective customer‑service interactions.
• Conduct claim reviews independently with insureds and agents.
• Handle increasingly complex issues with interest and ability.
• Maintain a positive attitude and exhibit consistent professionalism.
• Demonstrate creativity and independently conduct research.
• Maintain regular and predictable attendance.
• Perform other duties as assigned.

Education

College degree preferred.

Experience

Minimum 2–3 years of experience in handling Workers’ Compensation claims preferred.

Other Qualifications

• Thorough understanding of personal computing, typing skills, technology, and use of mobile devices.
• Basic understanding of medical terminology, treatment, physiology, and anatomy.
• Understanding of Workers’ Compensation statutes and case law.
• Demonstrated sustained excellence over a prolonged period.
• Excellent written and verbal communication skills.
• Ability to independently conduct claim reviews and service presentations to agents and potential new insureds.
• Experience handling litigated claims, including attending pre‑hearings, mediations, and hearings.
• Mentoring experience or willingness to volunteer for job shadowing and training activities.
• Participation in or conduct of training sessions for unit and/or department.
• Accompanied Special Investigations Unit on field claim investigations.
• Ability and willingness to provide quality customer service.
• Self‑starter who creates new opportunities.
• Ability to work both independently and collaboratively.
• Proven organizational and time‑management skills.

Acuity does not sponsor applicants for U.S. work authorization.

Pay

The salary range for this position is $75,000 – $90,000 annually. This range is an estimate; actual salary will vary based on the applicant’s education, experience, knowledge, skills, and abilities. The role is classified as exempt.

Benefits

• Comprehensive benefits package
• Generous 401(k) contribution
• Medical, dental, vision, life, and disability insurance
• Paid time off
• Employee Assistance Program
• Additional benefits and eligibility details provided during the hiring process