WC Claims Resolution Specialist - Special Risk Policyholders
$31,200–$31,200 year
HybridCharlotte, North Carolina, United States or Phoenix, Arizona, United States
Job Summary
Investigate losses, determine coverage, and assess compensability for workers' compensation claims involving large deductibles and retrospectively rated policies. Conduct thorough investigations, evaluate claims, and develop proactive resolution strategies including damage evaluations, negotiations, and settlements. Collaborate with legal counsel on litigated claims, establish accurate reserves, and partner with insureds and medical providers to facilitate safe returns to work. Prepare detailed claim summaries and reserve updates while mentoring other claims handlers. This hybrid role requires Texas expertise and 5 years of experience handling medium to high severity claims.
Required Qualifications
- Bachelor's degree or equivalent combination of education and experience
- 5 years of experience handling workers' compensation claims of medium to high level of severity/complexity
- Ability to obtain appropriate state licensing as required
- Proficient computer skills including Microsoft Office Suite
- Demonstrated ability to build positive relationships and partnerships within department, across the organization and with external customers
- Strong analytical skills and attention to detail
- Excellent verbal and written communication skills with the ability to interact with internal and external customers
- Ability to travel overnight up to 15%
- Texas expertise
- Ideally Arizona, Arkansas and Oklahoma
Desired Qualifications
- Experience managing litigated claims
- Experience developing and executing proactive claim resolution strategies
- Experience establishing and maintaining accurate claim reserves
- Experience identifying and engaging external resources
- Experience partnering with insureds, medical providers, and injured workers to facilitate a safe and timely return to work
- Experience collaborating with agents, policyholders, and internal stakeholders to analyze claims trends
- Experience implementing risk mitigation strategies
- Experience providing claims education
- Experience understanding and assessing loss-sensitive insurance programs such as large deductibles or retrospectively rated policies
- Experience mentoring and training other claims handlers
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