Manage within company standards and best practices complex and problematic high visability workers' compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim.

1. Receives claim, confirms policy coverage & acknowledgement of claim
2. Determine validity & compensability of claim by investigating & gathering infor, file necessary documentation with state agencies
3. Establish reserves & authorize payments within reserving authority limits
4. Develop and manage well documented action plan with case manager, attorney, supervisor & client to reduce overall cost of claim
5. Coordinating early return to work efforts with case manager & employer
6.Negotiates settlements when necessary
7. Actively manage the litigation process
8. Identifies potential subrogation claims
9. Communicate claim status with customer and claimant
10.Adhere to client guidelines & participate in claim reviews as needed
11.Develops & maintains professional customer relationships
 

Education-Four year degree at an accredited college or university preferred
Experience - Three years of Worker Compensation lost time claims management required
1. Excellent oral, written communication skills & customer service
2. PC literate, including Microsoft Office (Word, Excel)
3. Effective analytical & interpretive skills
4. Strong organizational skills
5. Great interpersonal skills
6. Ability to work in a team environment
7. Ability to work independently
8. Knowledge of the entire claims administration, case management, & cost containment solution as applicable to Worker Compensation