Workers Compensation Claims Representative

Job Summary

Responsible for investigating, evaluating, and negotiating settlement of Workers Compensation Loss Time claims, the full-time remote Claims Workers Compensation Loss Time Representative will oversee vendor and legal activities while ensuring excellent customer service and compliance with handling commitments.

Key responsibilities

• Investigate, negotiate, and resolve assigned Workers Compensation claims within authorized limits
• Establish and maintain positive relationships with internal and external customers, ensuring timely communication and compliance with special handling commitments
• Manage litigated and large catastrophic claims, utilizing medical cost management resources to facilitate early return to work

Required qualifications

• Proven experience in handling Workers Compensation claims
• Knowledge of Workers' Compensation laws and claim handling procedures in designated states
• Experience managing vendor activities and expense payments
• Ability to effectively manage loss severity and pursue claims involving subrogation and potential fraud
• Strong understanding of claim reserve practices and state reporting requirements