Major Responsibilities:

​Must possess analytical skills and be able to work with a sense of urgency and accuracy. Must be able to adhere to multiple state workers’ compensation rules, regulations, and laws.​Establish standards and procedures for all matters relating to the claims functions. ​ ​​Develop, maintain, and modify, when needed, effective procedures to ensure timely claims resolution ​maintaining a specialized base of knowledge regarding claims negotiation and settlement techniques.​​ ​​​Must function as a resource to the injured teammates, leaders, and others with an interest in the claim. ​​ Acts as a resource to the Workers Compensation team on audit work, processes and other complex issues.​​Recommend reserves, settlements, or other actions. Ensuring that these actions meet company standards and the liability, damages, coverages, etc. have been rigorously evaluated. Provide proper and timely analysis of coverage including MMSEA (Medicare, Medicaid and SCHIP Extension Act) Reporting.​ ​​​Must be able to communicate with the injured teammate and other parties, as necessary. ​ ​​Monitor reserves and settlements associated with claims and provide appropriate reports as needed to leadership.​ ​​Maintain claims data in such a manner that monthly reports for loss forecasting and trend analysis may be conducted.​ Assist leadership in evaluating excess policies to ensure the most favorable terms and conditions for the organization. Assist in the development, recommendation and/or implementation of loss prevention activities. Participate as needed in educational programs such as orientations to ensure awareness of the procedures associated with claims documentation and settlement. Must be able to provide additional support for all other duties as assigned. 

Licensure, Registration, and/or Certification Required:

Adjusters license required for area of responsibility as required by specific jurisdiction as applicable.​

Education Required:

Bachelor's degree in related field.

Experience Required:

Typically requires 5 years of experience with Workers Compensation claims administration.

Knowledge, Skills & Abilities Required:

10+ years of experience with Worker's Compensation claims administration will be considered in lieu of possessing a bachelor's degree.Excellent Oral and written communication skills, organizational skills, attention to detail, computer skills, and ability to manage multiple tasks required.Demonstrated proficiency in working with Microsoft Excel, Access, and PowerPoint required.​​Experience with RMIS Systems preferred​.​​​Will limit access to protected health information (PHI) to the information necessary to do the job. ​Will share information only on a need-to-know basis for work purposes.​​ 

Physical Requirements and Working Conditions:

​​​This position requires travel, therefore, will be exposed to weather and road conditions. ​​ ​​Operates all equipment necessary to perform the job.​ ​​Exposed to a normal office environment.​ ​​Requires the ability to work rapidly and accurately under pressure and to manage many different issues and priorities simultaneously.​ 

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.