Workers Compensation Claims Examiner

Alliant Insurance Services

Alliant Insurance Services is one of the nation's largest and fastest-growing insurance brokerage and consulting firms. We operate through a network of specialized national platforms and local offices to offer our clients a comprehensive portfolio of solutions built on innovative thinking and personal service. Alliant is changing the way our clients approach risk management and benefits, so they can capitalize on new opportunities to grow and protect their organizations.

Summary

Responsible for reviewing, adjudicating and managing low- and mid-level workers' compensation claims in accordance with company guidelines, statutory regulations and best practices. Manages claims through well-developed action plans to an appropriate and timely resolution.

Essential Duties and Responsibilities

• Reviews and evaluates workers' compensation claims to determine compensability and benefits due on indemnity claims;
• Sets and manages reserve accounts, ensures that accurate levels are maintained and that documentation is on file with state agency;
• Develops and manages workers' compensation claims action plans and manages to resolution;
• Establishes and manages return-to-work plan; Identifies modified work opportunities to enable return to work;
• Coordinates claim action and processing with claimant and client;
• Approves claim payments, manages subrogation of claims and negotiates settlements;
• Develops effective working relationships with outside vendors and ensures professional client relationships;
• Communicates with injured workers, employers, doctors and attorneys;
• Composes medical examination assignments, letters and legal orders;
• Maintains a quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims;
• Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information);
• Other duties as assigned.

Qualifications

Education / Experience

Bachelor's Degree in business or equivalent combination of education and experience

Three (3) or more years of experience in workers' compensation field

Certificates and/or licenses as required by State regulation

Skills

Excellent verbal and written communication skills

Excellent presentation skills

Excellent customer service skills

Analytical skills with ability to interpret results

Strong organizational skills

Good interpersonal skills with ability to work in a team environment

Proficient in Microsoft Office Products