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Advance your career at Company Insurance- A Fortune 100 Company!
Under limited supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of high exposure and severity. Applies established medical management strategies on high dollar complex claims. Has developed high level knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics.
1. Investigates claims to determine whether coverage is provided, establish compensability and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Examining on cases which exceed authority.
2. Participates in pricing, reserving and strategy discussions with HO Examining and Examining Management.
3. Works closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols.
4. Identifies and appropriately handles suspicious claims and claims with the potential to develop adversely.
5. Identifies and appropriately handles claims with third party subrogation potential, SIF and MSA exposure.
6. Establishes and maintains accurate reserves on all assigned files. Makes timely reserve recommendations to Branch Office Management and HO Examining on cases which exceed authority.
7. Prepares for and attends mediation sessions and/or settlement conferences and negotiates on behalf of LMG and LMG Insureds.
8. Demonstrates the ability to understand new and unique exposures and coverages.
9. Demonstrates the ability to understand key data elements and claims related data analysis.
10. Confers directly with policyholders on coverage and resolution strategy issues.
Coordinates and participates in training sessions for less experienced staff, including both Complex & non-Complex staff.
A Bachelors degree or equivalent business experience is required. In addition, the candidate will generally posses 5-7 years of related claims experience with 1-2 years of experience in complex claims. Demonstrated proficiency in Excel, PowerPoint as well as excellent written and verbal communication skill required.
We value your hard work, integrity and commitment to positive change. In return for your service, it’s our privilege to offer you benefits and rewards that support your life and well-being. To learn more about our benefit offerings please visit: Company website
At Company, we give motivated, accomplished professionals the opportunity to help us redefine what insurance means; to work for a global leader with a deep sense of humanity and a focus on improving and protecting everyday lives. We create an inspired, collaborative environment, where people can take ownership of their work; push breakthrough ideas; and feel confident that their contributions will be valued and their growth championed.
We’re dedicated to doing the right thing for our employees, because we know that their fulfillment and success leads us to great places. Life. Happiness. Innovation. Impact. Advancement. Whatever their pursuit, talented people find their path at Company.
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