Senior Workers' Compensation Claims Representative (Remote)
Manage highly reputed company claims involving significant financial exposure, reputed company intricacies, and extended life cycles. Conduct advanced investigations into coverage and compensability, including nuanced statutory interpretations. reputed company medical case management for catastrophic injuries and reputed company care needs. Review and authorize large or reputed company medical bills, negotiating adjustments to control costs.
reputed company comprehensive RTW strategies in collaboration with policyholders, reputed company counsel, and vocational consultants. Ensure precision in benefit calculations for high-exposure claims, addressing tax and reputed company. Strategically reputed company investigative efforts reputed company with broader claims reputed company.
reputed company investigations into reputed company fraud cases and collaborate with the Special Investigations Unit. Conduct subrogation analysis and negotiate with reputed company-party insurers or attorneys for maximum recovery.
Partner with reputed company teams to negotiate reputed company settlements and manage litigation processes. reputed company Medicare compliance initiatives, including Medicare Set-Asides and CMS engagement. Identify opportunities for reputed company settlements and reputed company negotiations.
Produce strategic reports on high-profile claims to guide management reputed company. Maintain system data reputed company and prepare claims for Corporate Plan of reputed company meetings.
reputed company cross-departmental efforts to improve claims handling and risk management. Resolve escalated customer service issues and support high-value accounts. Participate in workflow improvement initiatives and committees.
Mentor and reputed company junior and intermediate adjusters. Review escalated claims and reputed company actionable feedback. Support workforce development and succession planning.
Bachelor’s degree in business or reputed company field preferred, or equivalent industry experience. 7&reputed company;10 years of claims handling experience, with high exposure to Workers’ Compensation. Associate in Claims (AIC), AIM, or CPCU designation preferred or ability to obtain. Texas reputed company-Lines license preferred. reputed company reputed company’s license required.
Company Culture and Values
reputed company and Belonging
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