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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates advanced knowledge of workers' compensation claims handling, including litigation management and resolution strategies. Capable of effectively communicating with stakeholders and providing technical guidance on complex claims while ensuring compliance with regulatory standards.
Highest-signal resume keywords
Workers’ Compensation CertificationComplex Litigated Claims ExperienceClaims Handling ExperienceState Workers Compensation LicenseAdvanced Knowledge of Claims Resolution Strategies
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 ManagementClaims InvestigationMediation and NegotiationClaims Data AccuracyLegal Document AnalysisReport WritingClaims Resolution StrategiesReserving AdjustmentsCustomer ServiceRegulatory Compliance
Soft Skills
Excellent Verbal CommunicationTime ManagementAttention to DetailOrganizational SkillsFlexibility
Certifications & Qualifications
Workers’ Compensation CertificationWCCAWCCP
Industry Keywords
Claims ProceduresLitigation ManagementMedical Exposure ClaimsRegulatory ReportingProcess StreamliningLegal Fees MonitoringInjured-Worker BenefitsCase Law TrackingStakeholder ReportingClaims Resolution
About the role
Key responsibilities & impact- Manage all aspects of a moderate to highly complex claims inventory
- 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, and offers to drive claim resolution
- Operate within state or governing-entity rules, regulations, and internal claims procedures
- Direct defense counsel through litigation while monitoring legal fees and costs
- Collaborate with team members across departments on projects and process discussions
- Recommend process streamlining and industry best practices
- Ensure claims-system data accuracy for regulatory reporting
- Provide knowledge transfer, mentoring, and training to less experienced team members
- Attend job-related training and track current case law
- Prepare and present claims status reports for internal and external stakeholders
- Administer, manage, and approve injured-worker benefits within authority levels
- Create and adjust reserves according to company policies
- Resolve claims fairly and equitably while providing timely legally required benefits
- Provide technical guidance on complex claim resolution and specialty handling initiatives
- Handle complex medical exposure, litigation, fatality, PTD, life pension, and long-term resolution claims
- 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 5+ years’ related claims handling experience required
- Complex litigated claims experience highly preferred
- Workers’ Compensation certification meeting minimum training, experience, and skill standards
- WCCA and WCCP preferred
- State Workers Compensation License required in some branches
- Good understanding of laws and jurisdictional restraints to manage claims
- Excellent verbal communication, time management, attention to detail, and organizational skills
- Adept at learning 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 common 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
- Employment sponsorship is not offered for this opportunity
Benefits
Comp & perks- Competitive benefits package
- Medical, dental, and vision plans
- 401K retirement plan with company match
- Bonus potential
- 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