Claims Representative II

Claims Professional

Key Risk is looking for a claims professional who enjoys analysis and management of workers compensation claims.

Key functions include but are not limited to the following :

• Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
• Negotiates settlement of claims up to designated authority level and makes claims payments.
• Calculates and assigns timely an appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level.
• Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
• Prepares necessary state filings within statutory limits.
• Actively manages the litigation process; ensures timely and cost-effective claims resolution.
• Coordinates vendor referrals for additional investigation and / or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
• Frequently communicates with all appropriate parties involved with the claim.
• Maintains professional client relationships.
• Actively executes appropriate claims activities to ensure consistent delivery of quality claims services.

Qualifications :

Additional Company Details :

We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details : Sponsorship not Offered for this Role