Senior Workers Compensation Claim Representative
Core
Manage Workers' Compensation claims with lost time, negotiate settlements, and coordinate medical and indemnity positions to resolve claims involving injuries from minor sprains to complex surgeries and fatalities.
Role type
Senior Workers Compensation Claim Representative
Builds
Resolved claims files and settlement agreements for injured workers
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
Claim investigation, Reserve setting, Medicare Set Aside management, Litigation management, Settlement negotiation, Fraud evaluation, Vocational Rehabilitation coordination, Policy interpretation
Preferred skills
Mentorship of claim professionals, Structured settlement/annuity structuring, Specialized account management
Technologies
None stated
Responsibilities
Conduct investigations to determine compensability; Establish and update actuarial reserves; Manage moderate to complex litigation; Negotiate claim settlements; Coordinate with Medical Case Managers; Evaluate claims for potential fraud; Prepare state filings and pursue offset opportunities; Mentor other Claim Professionals.
Seniority
Senior, hands-on IC with mentorship responsibilities