Sr. Workers Compensation Claims Rep (Paid Relocation Available)
Senior WC Claims Representative
Tupelo, MS, USA
(Paid Relocation Available)
Will be working on site on in a very high visibility/ high growth position with Fortune 100 company
Adjust assigned workers' compensation complex medical, life-time medical or lost time claims within delegated limits of authority, conduct timely and thorough investigations and complete fair and equitable claim settlements in accordance with Claim Handling Guidelines and State Regulatory Compliance Requirements. Ensure that all claims services are provided in a fair, equitable and timely manner by performing the following duties:
Essential Duties and Responsibilities include the following. Other duties may be assigned.
1. Receives new claim assignments; analyzes the nature of the claim to determine required investigation and handling. Determines and identifies compensability issue or questions of compensability in accordance with the Claims Handling Guidelines.
2. Performs timely and thorough investigations in an effort to comply with all jurisdictional requirements and/or entitlements.
3. Conducts an informed case analysis to address claim entitlements, initiate reserve changes within assigned authority, makes recommendations to supervisor or manager where assigned authority is exceeded.
4. Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claims practice requirements and company policy and procedures.
5. Investigates, evaluates and resolves all litigated files including all aspects of litigation management in accordance with the Claims Handling Guidelines.
6. Maintains current case diary and ensures appropriate hard copy file documentation. Provides accurate claims system documentation as required by company claim manuals and procedures. Responsible for completion and/or submission of claim forms and reports as required by outside agencies.
7. Investigates and evaluates recovery potential. Conducts timely and thorough subrogation investigation in accordance with company policy and procedures. Timely completion and referral of all claims involving recovery potential.
8. Service the claim needs of our customers, including insureds, claimants, brokers, etc. in accordance with company policy and procedures.
9. Partner with internal and external customers to bring about an appropriate claim resolution in a timely and effective manner in accordance with the Claims handling Guidelines
Education and Experience
High School Degree or G.E.D. Bachelor's degree preferred.
5
years related WC claims experience
Licensing in MS is required
Detail oriented and a team player
Excellent Customer Service experience
Excellent written and verbal communication skills
Intermediate Microsoft knowledge
Estimated Salary: $20 to $28 per hour based on qualifications.
Tupelo, MS, USA
(Paid Relocation Available)
Will be working on site on in a very high visibility/ high growth position with Fortune 100 company
Adjust assigned workers' compensation complex medical, life-time medical or lost time claims within delegated limits of authority, conduct timely and thorough investigations and complete fair and equitable claim settlements in accordance with Claim Handling Guidelines and State Regulatory Compliance Requirements. Ensure that all claims services are provided in a fair, equitable and timely manner by performing the following duties:
Essential Duties and Responsibilities include the following. Other duties may be assigned.
1. Receives new claim assignments; analyzes the nature of the claim to determine required investigation and handling. Determines and identifies compensability issue or questions of compensability in accordance with the Claims Handling Guidelines.
2. Performs timely and thorough investigations in an effort to comply with all jurisdictional requirements and/or entitlements.
3. Conducts an informed case analysis to address claim entitlements, initiate reserve changes within assigned authority, makes recommendations to supervisor or manager where assigned authority is exceeded.
4. Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claims practice requirements and company policy and procedures.
5. Investigates, evaluates and resolves all litigated files including all aspects of litigation management in accordance with the Claims Handling Guidelines.
6. Maintains current case diary and ensures appropriate hard copy file documentation. Provides accurate claims system documentation as required by company claim manuals and procedures. Responsible for completion and/or submission of claim forms and reports as required by outside agencies.
7. Investigates and evaluates recovery potential. Conducts timely and thorough subrogation investigation in accordance with company policy and procedures. Timely completion and referral of all claims involving recovery potential.
8. Service the claim needs of our customers, including insureds, claimants, brokers, etc. in accordance with company policy and procedures.
9. Partner with internal and external customers to bring about an appropriate claim resolution in a timely and effective manner in accordance with the Claims handling Guidelines
Education and Experience
High School Degree or G.E.D. Bachelor's degree preferred.
5
years related WC claims experience
Licensing in MS is required
Detail oriented and a team player
Excellent Customer Service experience
Excellent written and verbal communication skills
Intermediate Microsoft knowledge
Estimated Salary: $20 to $28 per hour based on qualifications.
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