Workers Compensation Return to Work Claim Representative
Core
Manage Workers' Compensation claims with lost time, negotiate settlements, and coordinate medical/indemnity positions to facilitate return to work or achieve Maximum Medical Improvement.
Role type
Workers Compensation Claim Representative
Builds
Claim resolutions, settlements, and return-to-work strategies for injured workers
Domain
Insurance / Workers Compensation
Deliverable
client delivery
Required skills
Workers Compensation claim handling, policy coverage assessment, reserve establishment, medical case management, litigation management, settlement negotiation, fraud evaluation, Medicare Set Aside analysis
Preferred skills
Insurance licensing, structured settlement knowledge, vocational rehabilitation coordination
Technologies
None explicitly stated
Responsibilities
Conduct investigations to determine compensability, establish and update actuarial reserves, manage files with emphasis on quality and timely closure, collaborate with medical and legal resources, pursue offset opportunities, negotiate claim settlements, evaluate claims for potential fraud, manage litigation to optimal outcomes
Seniority
Mid-level, 2+ years experience