Senior Claims Specialist

About This Role

Handle complex and high-profile Workers' Compensation claims, working closely with case managers and attorneys to manage subrogation and negotiate settlements for optimal claim outcomes and customer satisfaction.

Responsibilities

• Receive claim, confirm policy coverage, and acknowledge the claim
• Determine validity and compensability of the claim by investigating and gathering information, filing necessary documentation with state agencies
• Establish reserves and authorize payments within reserving authority limits
• Develop and manage action plans with case and outcomes managers to reduce overall claim cost
• Coordinate early return-to-work efforts with appropriate parties
• Manage subrogation and litigation of claim as applicable
• Manage potential claim recoveries of all types
• Report claims to the excess carrier when applicable
• Communicate claim status with the customer and claimant
• Adhere to client and carrier guidelines and participate in claims review as needed
• Develop and maintain professional customer relationships
• Comply with rules and regulations of applicable state

Requirements

• Minimum of 6 years’ industry experience and claim handling
• Excellent written and verbal communication skills
• Computer proficiency and technical aptitude with MS Office including Excel
• Knowledge of claims administration, case management and cost containment solution for Workers’ Compensation

Qualifications

• Bachelor's degree or a combination of education and related experience
• Minimum of 6 years’ industry experience and claim handling

Skills

* Required skills

Benefits

Certifications