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Workers' Compensation Claims Analyst

Optimal Inc.

Job Description

Job Description

Position Description:
Primary Workers' Compensation Claims Handler at the Plant with a focus on excellent customer service, quality claims handling, and loss cost management. Plant-based position. Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.

Job Responsibilities:

  • Ability to handle a full case load, with proven ability to handle cases of increased severity.
  • Workers' Compensation Lost Time claim handling experience
  • Manage claims through well-developed action plans to ensure timely and cost-effective resolutions.
  • Calculate and assign timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  • Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle clams within designated authority level.
  • Prepare necessary state fillings within statutory limits.
  • Coordinate vendor referrals for additional investigation and/or litigation management.
  • Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
  • Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Report claims to the excess carrier.
  • Communicate claim activity and processing with the claimant and the client.

Skills Required:
Claims, Customer Service

Experience Required:
3-5 years of Illinois Workers' Compensation claims management experience

Education Required:
High School Diploma / GED

Full Onsite

Vacancy posted 3 days ago
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