ABOUT THE ROLE
Leading provider of innovative solutions claims handling and Risk Management in the Healthcare space seeks a Work Comp Claims professional to join their dynamic team. In this role, the individual will be responsible for managing the entire claims process for workers' compensation cases, from initial reporting through resolution. They will work closely with carriers, employers, medical providers, and legal representatives to ensure timely and fair claim settlements.
DUTIES & RESPONSIBILITIES
Review and analyze workers' compensation claims to determine eligibility and coverage.
Conduct investigations, including gathering documents and coordinating with medical professionals.
Evaluate medical records and reports to assess the extent of injuries.
Negotiate settlements and ensure that claims are handled in accordance with applicable laws and regulations.
Collaborate with legal teams and external vendors as necessary to defend claims and manage disputes.
REQUIRED EDUCATION AND EXPERIENCE
Minimum of 5 years of experience in workers' compensation claims adjusting.
Strong knowledge of workers' compensation laws, regulations, and best practices.
Excellent analytical, organizational, and problem-solving skills.
Strong communication skills, both verbal and written.
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