Indemnity Claims Examiner

Manage within company standards and best practices complex and problematic high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer service requirement to achieve the best possible outcome in the claim.

ESSENTIAL JOB DUTIES:
1. Receive claim and acknowledgement of the claim
2. Determine validity and compensability of the claim by investigating and gathering information regarding the claim
3. Establish reserves and authorize payments within reserving authority limits
4. Develop and manage well documented action plan with the case manager and outcomes manager to reduce overall cost of the claim
5. Coordinating early return-to-work efforts with the case manager and employer
6. Manages subrogation of the claim
7. Negotiates settlements when necessary
8. Actively manage the litigation process
9. Manage potential claim recoveries of all types
10. Communicate claim status with the customer and claimant
11. Adhere to client and carrier guidelines and participate in claims review as needed
12. Develop and maintains professional customer relationship
13. Requires regular and consistent attendance

KNOWLEDGE & SKILLS:
1. Excellent oral and written communication skills
2. PC literate, including Microsoft Office (Word, Excel)
3. Strong organizational skills
4. Good interpersonal skills
5. Ability to work in a team environment
6. Knowledge of claims administration, case management and cost containment solution as applicable to Workers' Compensation

EXPERIENCE:
3-5 years of Workers' Compensation claims management experience required.
Must have experience adjusting Work Comp Claims.