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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates advanced expertise in managing complex claims, including litigation management, reserving, and settlement strategies. Possesses strong communication and organizational skills to effectively collaborate with stakeholders and ensure compliance with regulatory requirements.
Highest-signal resume keywords
Complex Claims HandlingWorkers’ Compensation CertificationLitigation ManagementClaims Resolution StrategiesRegulatory Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims Inventory ManagementMediation and NegotiationClaims Data AccuracyReserving StrategiesLegal Document AnalysisClaims Status ReportingProcess ImprovementCustomer ServiceTechnical GuidanceSettlement Strategy
Soft Skills
Verbal CommunicationTime ManagementAttention to DetailOrganizational SkillsFlexibility
Certifications & Qualifications
Workers’ Compensation CertificationWCCAWCCPState Workers Compensation License
Industry Keywords
Claims HandlingLitigationRegulatory ReportingHigh Exposure ClaimsComplex LitigationMedical ManagementCatastrophic InjuriesTimely BenefitsStrategic InitiativesCross-Functional Collaboration
About the role
Key responsibilities & impact- Manage complex claims inventories requiring advanced technical expertise and strategic claim handling
- Communicate with policyholders, agents, attorneys, and witnesses to gather information and provide customer service
- Investigate claims to determine exposure, work with experts, and make strategic recommendations
- Use mediation, negotiation, denial, litigation, or offers to drive claim resolutions
- Follow state or governing-entity rules, regulations, and internal claims-handling policies
- Direct defense counsel throughout litigation and monitor legal fees and costs
- Collaborate with cross-functional team members on projects and process discussions
- Recommend process improvements and industry best practices
- Ensure claims-system data accuracy for regulatory reporting
- Provide knowledge transfer and mentor or train less experienced team members
- Prepare and present claims status reports for internal and external stakeholders
- Administer, manage, and approve benefits payments to injured workers within designated authority
- Create and adjust reserves in accordance with company policies
- Resolve claims fairly and equitably while providing legally required timely benefits
- Support specialty claim programs and strategic initiatives involving complex litigation, medical exposure, catastrophic injuries, fatalities, PTD, and long-duration claims
- Provide technical guidance to leadership on complex claim resolution strategies
- Drive resolution of complex or long-duration claims through settlement, reserving, and medical-management strategies
Requirements
What you’ll need- Bachelor's degree (or equivalent combination of education and experience) required
- Minimum of 8–10+ years’ related claims handling experience involving complex litigation, reserving, settlement strategy, and high exposure claims
- Workers’ Compensation certification meeting minimum standards of training, experience, and skill required
- WCCA and WCCP preferred
- State Workers Compensation License required in some branches
- Excellent understanding of laws and jurisdictional restraints to manage claims
- Excellent verbal communication, time management, attention to detail, and organizational skills
- Ability to learn new technology
- Flexibility to adapt to changes in a fast-paced environment
- Ability to read, analyze, and interpret technical and legal documents
- Ability to write reports and business correspondence
- Ability to respond to inquiries or complaints from customers, claimants, and regulatory agencies
- Ability to present information at meetings to management and clients
- Ability to solve practical problems and deal with varied situations with limited standardization
- Advanced knowledge of workers’ compensation claims handling, reserving, litigation management, and resolution strategies
- No employment sponsorship is offered for this opportunity
Benefits
Comp & perks- Competitive benefits package
- Medical, dental, and vision plans
- 401K retirement plan with company match
- Bonus potential for all positions
- Paid Time Off
- Paid holidays throughout the calendar year
- 100% support for continued learning
- Challenging work and the ability to make a difference
- Voice and sense of belonging