Senior Workers Compensation Claim Representative
Core
Manage Workers' Compensation claims with lost time, negotiate settlements, and coordinate medical and indemnity positions to resolve claims and return injured workers to work.
Role type
Senior Workers Compensation Claim Representative
Builds
Resolved claims files and settlement agreements
Domain
Insurance / Workers' Compensation
Required skills
claim investigation, reserve estimation, Medicare Set Aside, litigation management, settlement negotiation, fraud evaluation, vocational rehabilitation coordination, policy coverage assessment, actuarial reserve setting, structured settlement planning
Preferred skills
deep technical expertise in complex claims, mentorship of claim professionals, management of special account relationships
Technologies
none stated
Responsibilities
Conduct investigations to determine compensability; establish and update actuarial reserves; manage moderate to complex litigation; negotiate claim settlements; evaluate claims for potential fraud; coordinate with medical case managers; mentor other claim professionals; prepare state filings and letters; pursue offset opportunities including subrogation and contribution.
Seniority
Senior, hands-on IC with mentorship responsibilities