Workers Compensation Critical Claim Specialist
Core
Manage high exposure Workers Compensation claims involving catastrophic loss, serious injury, and complex medical/legal issues to achieve resolution.
Role type
Senior Workers Compensation Critical Claim Specialist
Builds
Resolved claims and settlements for injured workers and employers
Domain
Insurance / Workers Compensation
Deliverable
client delivery
Required skills
Workers Compensation claims management, reserve setting, Medicare Set Aside analysis, structured settlement negotiation, subrogation, vocational rehabilitation coordination, state/federal insurance law application, medical injury assessment, investigative statement taking
Preferred skills
Insurance licensing, actuarial reserving, litigation support, complex offset management
Technologies
Structured settlement annuities, telephonic review platforms
Responsibilities
Evaluate and manage high exposure claims including catastrophic loss and fatalities; Establish and update actuarial reserves; Develop strategies to resolve complex statutory benefit and medical diagnosis issues; Co-manage claims with Major Case Unit for disability projections; Pursue offset opportunities including apportionment and subrogation; Act as technical resource for internal teams
Seniority
Senior, hands-on IC
