Workers Compensation Claims Examiner

About the company

Alliant Insurance Services is one of the nation’s largest and fastest-growing insurance brokerage and consulting firms. We operate through a network of specialized national platforms and local offices to offer clients a comprehensive portfolio of solutions built on innovative thinking and personal service.

About the role

Responsible for reviewing, adjudicating and managing low- and mid-level workers' compensation claims in accordance with company guidelines, statutory regulations and best practices. Manages claims through well-developed action plans to an appropriate and timely resolution.

Responsibilities

• Reviews and evaluates workers’ compensation claims to determine compensability and benefits due on indemnity claims.
• Sets and manages reserve accounts, ensures that accurate levels are maintained and that documentation is on file with state agency.
• Develops and manages workers’ compensation claims action plans and manages to resolution.
• Establishes and manages return-to-work plan; identifies modified work opportunities to enable return to work.
• Coordinates claim action and processing with claimant and client.
• Approves claim payments, manages subrogation of claims and negotiates settlements.
• Develops effective working relationships with outside vendors and ensures professional client relationships.
• Communicates with injured workers, employers, doctors and attorneys.
• Composes medical examination assignments, letters and legal orders.
• Maintains a quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims.
• Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information).
• Other duties as assigned.

Requirements

• Bachelor's Degree in business or equivalent combination of education and experience.
• Three (3) or more years of experience in workers’ compensation field.
• Certificates and/or licenses as required by State regulation.

Skills

• Excellent verbal and written communication skills.
• Excellent presentation skills.
• Excellent customer service skills.
• Analytical skills with ability to interpret results.
• Strong organizational skills.
• Good interpersonal skills with ability to work in a team environment.
• Proficient in Microsoft Office Products.

Benefits

We provide comprehensive, high quality employee programs to meet employees' needs now and in the future, including a very competitive financial package.