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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 resolutions
- Operate within state or governing-entity regulations and internal claims policies
- Direct defense counsel throughout litigation while monitoring legal fees and costs
- Collaborate with cross-departmental team members on projects and processes
- 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 for injured workers within designated authority
- Create and adjust reserves according to company policies
- Resolve claims fairly and equitably while providing timely benefits as required by law
- Provide technical guidance on complex claim resolution strategies and specialty handling initiatives
- Handle complex medical exposure, litigation, fatality, PTD, life pension, and long-term resolution claims
- Drive resolution opportunities through settlement, reserving, and medical management strategies
- Track current case law and attend job-related training
- Work in an office environment using computers, telephones, copiers, and standard office equipment
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 standards of training, experience, and skill required
- State Workers Compensation License required in some branches
- Advanced knowledge of workers’ compensation claims handling, reserving, litigation management, and resolution strategies
- Good understanding of laws and jurisdictional restraints
- Excellent verbal communication, time management, attention to detail, and organizational skills
- Adept at learning new technology
- 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 with limited standardization
- Ability to adapt to changes in a fast-paced environment
- No employment sponsorship 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 ability to make a difference
- Voice and sense of belonging
- Diverse work environment