Job Details

As a Claims Representative, you will be responsible for the investigation, evaluation, mitigation and resolution of medical only and lost time workers' compensation claims of moderate complexity in multiple jurisdictions. Investigate workers' compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due. Calculate and set timely financial reserves and proactively manages reserve adequacy throughout claim lifecycle. Record and code injured worker demographics, job information and accident information in company's claims management system and files necessary forms with state regulatory agencies. Issue timely payments to injured workers, medical providers and service vendors. Coordinate and actively manage medical treatment of injured workers to ensure timely rehabilitation. Negotiate settlements of claims within designated authority with injured workers and attorneys. Demonstrate a working knowledge of t...Claims Representative, Claims, Representative, Worker, Skills, Management