Workers Compensation Specialist
The ideal candidate will have a strong knowledge of Workers’ Compensation claims practices, reserve setting, Return to Work options and loss histories. As the Workers’ Compensation Specialist, you will work with various insurance carriers to assure that open claims are proceeding in a reasonable and prompt manner. In addition you will obtain claim updates and direct claim reviews for the Clients. You will be assisting our Clients in the management of their Workers’ Compensation claims, both pre-loss and post-loss. The ability to multi-task in a fast-paced environment is essential as well as excellent written communication skills. You will have the ability to grow in your job and enhance your insurance knowledge on an ongoing basis.
B. Five years claims experience in Workers’ Compensation
C. Preferred Qualifications:
Good understanding of Workers’ Compensation procedures in Illinois and other states.
- Good organizational skills. Detail oriented.
- Ability to work effectively under pressure.
- Good written and verbal communications.
- Ability to communicate clearly by telephone.
- Familiarity with software (Microsoft Word, Outlook, Power Point, Excel)
A. To monitor Clients’ open Workers’ Compensation Claims over a designated dollar amount to determine the best course of action to bring the claim to closure. Oversight duties include working closely with adjusters, nurse case managers and Clients to examine reserve setting, appropriate medical treatment, need for IME, return to work and settlement.
B. Host regularly scheduled Claim Reviews, individually or in conjunction with adjusters, for Clients.
C. Primary liaison with Alper’s Early Intervention triage nurses provided by an outside vendor.
D. Educate Clients on ways to reduce or eliminate their claims, e.g. review of loss histories for trends requiring re-training, loss control, etc. Presenter at seminars hosted throughout the year by Alper.
E. Update the Client regularly on the status of open claims.
F. Working with the Client to set up a modified duty return to work program.
G. Assist Clients in locating resources for occupational health clinics, drug testing, flu shots, etc.
H. Work with the Account Executive, for marketing purposes, including presentations to prospective Clients.
I. Maintain a library of pertinent health care reference materials.
J. Attend professional organization meetings and seminars. Receive periodicals and journals to remain up to date on current health care
K. Problems as it relates to Workers’ Compensation.
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