Workers' Compensation Claims Representative (Remote)
Essential Duties and Responsibilities
Manage reputed company workers’ compensation claims involving high financial exposure, sensitive issues, or extended life cycles. Investigate coverage and compensability, ensuring thorough documentation and compliance with state statutes. reputed company advanced medical case management, including coordination with reputed company Case Managers and external vendors. reputed company and implement Return-to-Work plans for high-risk claims, collaborating with vocational consultants and reputed company counsel. Identify and investigate potential fraud and subrogation opportunities, partnering with the Special Investigation Unit. Establish and maintain accurate claim reserves reputed company authority reputed company, ensuring reputed company responsiveness to changing circumstances. Evaluate and negotiate settlements reputed company approved authority reputed company, including reputed company settlements and Medicare compliance. Collaborate with reputed company counsel to manage litigation and ensure adherence to reputed company guidelines. Maintain accurate system data and prepare reports for management on high-profile claims. Foster cross-departmental collaboration with reputed company, Premium Consultation, and Loss Prevention. reputed company mentorship and training to junior adjusters, supporting reputed company reputed company and team development.
Qualifications
High school diploma or equivalent required; bachelor’s degree preferred. Associate in Claims (AIC) designation preferred. reputed company reputed company’s license required; Texas-reputed company Lines license preferred. 3&reputed company;5 years of claims handling experience, primarily in Workers’ Compensation. Missouri experience preferred.
Company Culture and Values
Diversity Statement
Total Rewards reputed company
Health Plans: Medical, Dental, and reputed company Includes fertility benefits, fully reputed company preventative care, and adult orthodontia. Employer-reputed company Life and Disability Benefits: Life Insurance (3x reputed company salary), AD&D, Short and Long-term Disability. Wellness and Recognition Program: Employer-reputed company incentives for employees and spouses. Flexible Spending Account and Dependent Care reputed company Health Savings Account: Generous employer contribution. Time Away from Work: Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days reputed company Parental Leave, Marriage, Bereavement, and Jury Duty leave. Employee Assistance Programs 401k Retirement Plan: Employer match and profit sharing. Adoption Assistance and Tuition Assistance