Workers Compensation Plant Rep II

Key Responsibilities

• Analyze and investigate workers' compensation claims to determine exposure and claim strategy.
• Manage a full caseload of workers' compensation claims, including complex and high-severity matters.
• Handle Lost Time Workers' Compensation claims.
• Develop and execute claim action plans to achieve timely and cost-effective claim resolution.
• Establish, monitor, and adjust claim reserves throughout the life of the claim.
• Calculate and issue benefit payments and claim adjustments.
• Negotiate and settle claims within designated authority levels.
• Prepare and submit required state filings within statutory deadlines.
• Cookordination investigations, medical management, and litigation vendors.
• Implement cost-containment strategies and vendor partnerships.
• Manage claim recoveries, including: Subrogation, Second Injury Fund recoveries, Social Security offsets, Medicare offsets, and Report claims to excess insurance carriers.
• Communicate claim status and activity with claimants and stakeholders.
• Maintain accurate documentation and claims coding.
• Escalate complex matters to management as needed.

Required Qualifications

• 3–5 years of Workers' Compensation claims management experience.
• Experience handling Lost Time Workers' Compensation claims.
• Experience managing a full workers' compensation caseload.
• Ability to investigate, evaluate, and resolve claims independently.
• Experience with reserve analysis and claim payment administration.
• Knowledge of workers' compensation regulations and state filing requirements.
• High School Diploma or GED (Preferred: Bachelor's Degree).
• Experience handling complex or high-severity workers' compensation claims.
• Manufacturing, industrial, or plant environment experience.
• Litigation management experience.
• Recovery and subrogation experience.