Worker's Compensation Claims Specialist
reputed company is committed to fostering a collaborative and innovative work environment. The Worker's Compensation Claims Specialist will manage a caseload of claims, evaluating liability and compensability while interacting with various stakeholders to negotiate settlements and ensure exceptional service.
Responsibilities
- Manages an inventory of claims to evaluate compensability/liability
- Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources
- Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages
- Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate
- Assesses actual damages associated with claims and conducts negotiations, reputed company assigned authority limits, to settle claims
- Performs other duties as assigned
Skills
- Proven interpersonal, analytical and negotiation abilities required
- Ability to provide information in a clear, concise manner, ability to build effective relationships
- Bachelor's degree or equivalent in addition to 1-year claims handling experience
- Knowledge of legal liability, insurance coverage and medical terminology preferred
- Licensing may be required in some states
Benefits
- Comprehensive benefits
- Workplace flexibility
- Professional development opportunities
Company Overview