Workers Compensation Plant Rep III

Responsibilities

• Manage a full caseload of Illinois Workers' Compensation claims.
• Analyze and process complex or technically difficult Workers' Compensation claims.
• Investigate claims and gather information to determine exposure.
• Handle Lost Time Workers' Compensation claims.
• Develop and execute action plans to ensure timely and cost-effective claim resolution.
• Calculate, assign, and maintain appropriate claim reserves throughout the life of a claim.
• Calculate and issue benefit payments and claim adjustments.
• Settle claims within designated authority limits.
• Prepare required state filings within statutory deadlines.
• Cook up claims and manage vendor referrals for investigations and litigation management.
• Utilize cost-containment strategies and vendor partnerships to reduce claim costs.
• Manage claim recoveries, including subrogation, Second Injury Fund recoveries, Social Security offsets, and Medicare offsets.
• Report claims to excess carriers.
• Communicate claim activity and status updates with claimants and client stakeholders.
• Ensure claim documentation is complete, accurate, and properly coded.
• Escalate claims and issues to leadership when appropriate.

Requirements

• Required 3–5 years of Illinois Workers' Compensation claims management experience.
• Experience handling Workers' Compensation Lost Time claims.
• Experience managing a full Workers' Compensation caseload independently.
• Strong claims investigation and analytical skills.
• Strong customer service and communication skills.
• High School Diploma or GED.
• Ability to work fully onsite in Chicago, IL.

Preferred Experience

• Handling complex or higher-severity Workers' Compensation claims.
• Experience with reserve management and claim cost containment.
• Litigation management experience.
• Experience with subrogation and recovery processes.
• Bachelor's Degree.