Claims Examiner III, Workers Compensation

Responsibilities Responsible for the resolution of high complexity and high exposure Workers Compensation claims in multiple jurisdictions Confirms coverage of claims by reviewing policies and documents submitted in support of claims Analyzes coverage and communicates coverage positions Conducts, coordinates, and directs investigation into loss facts and extent of damages Directs and monitors assignments to experts and outside counsel Evaluates information on coverage, compensability, and medical management to determine the extent of insured's exposure Sets reserves within authority or makes claim recommendations concerning reserve changes to manager Focus on driving claims to a resolution with a focus on returning the injured back to work Evaluate, negotiate and settle claim when appropriate Prepares reports by collecting and summarizing information Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives Participates in special projects or assists other team members as requested Attend all state specific trainings as scheduled Travel to mediations, trials, and conferences as required Requirements A degree in business related courses optional in exchange for experience in insurance An insurance designation is a plus Excellent written and oral communication skills Strong analytical and problem solving skills Strong organization and time management skills Ability to deliver outstanding customer service Strong knowledge and understanding of medical terminology is a plus Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word) Ability to work in a team environmentStrong desire for continuous improvement US Work Authorization required #J-18808-Ljbffr