Workers' Compensation Representative

About the role

A Plant-based Workers' Compensation Claims Handler focused on excellent customer service, quality claims handling, and loss cost management.

Responsibilities

• Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claims.
• Ability to handle a full case load, with proven ability to handle cases of increased severity.
• Manage claims through well-developed action plans to ensure timely and cost-effective resolutions.
• Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim.
• Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle claims within designated authority level.
• Prepare necessary state filings within statutory limits.
• Cook appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
• Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Report claims to the excess carrier.
• Communicate claim activity and processing with the claimant and the client.
• Ensure claim files are properly documented, and claims coding is correct.
• Refer cases as appropriate to supervisor and management.

Requirements

• 3-5 years of Workers' Compensation claims management experience.
• High School Diploma / GED.
• Bachelor's Degree preferred.

Skills

• Workers' Compensation Experience.
• Customer Service Focus.
• Quality Claims Handling.
• Loss Cost Management.