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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates advanced knowledge of Workers' Compensation claims handling, including litigation management and resolution strategies. Capable of effectively communicating with various stakeholders and managing complex claims inventories while ensuring compliance with state regulations.
Highest-signal resume keywords
Workers' Compensation CertificationComplex Litigated Claims ExperienceClaims ManagementRegulatory ReportingNegotiation and Mediation Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims HandlingLitigation ManagementReserving StrategiesData AccuracyProcess StreamliningTechnical MentoringMedical ManagementClaims Inventory ManagementLegal Document AnalysisReport Writing
Soft Skills
Strong Verbal CommunicationTime ManagementAttention to DetailOrganizational SkillsFlexibility in Fast-Paced Environment
Certifications & Qualifications
Workers' Compensation CertificationWCCAWCCPState Workers Compensation License
Industry Keywords
Claims InventoryCustomer ServiceRegulatory ComplianceClaims ResolutionMediationNegotiationLitigationExposure DeterminationProcess DiscussionsClaims System
About the role
Key responsibilities & impact- Manage all aspects of a moderate to highly complex claims inventory
- Communicate with policyholders, agents, attorneys, and witnesses to gather information and provide customer service
- Investigate claims to determine exposure, work with experts, and make strategic recommendations
- Use mediation, negotiation, denial, litigation, or offers to drive claim resolutions
- Operate within state rules, regulations, and internal claims-handling policies
- Direct defense counsel through litigation while monitoring legal fees and costs
- Collaborate across departments on projects and process discussions
- Recommend process streamlining and adoption of industry best practices
- Ensure claims-system data accuracy for regulatory reporting
- Provide knowledge transfer, technical mentoring, and training
- Prepare and present claims status reports
- Administer and approve workers’ compensation benefits within authority levels
- Create and adjust reserves in accordance with company policies
- Handle complex medical exposure, litigation, fatality, PTD, life pension, and long-term claims
- Drive resolution through settlement, reserving, and medical-management strategies
Requirements
What you’ll need- Bachelor's degree or equivalent combination of education and experience required
- Minimum 5+ years of related claims-handling experience required
- Complex litigated claims experience highly preferred
- Workers’ Compensation certification meeting minimum training, experience, and skill standards
- WCCA and WCCP preferred
- State Workers Compensation License required in some branches
- Understanding of laws and jurisdictional restraints for claims management
- Advanced knowledge of workers’ compensation claims handling, reserving, litigation management, and resolution strategies
- Strong verbal communication, time management, attention to detail, and organizational skills
- Ability to learn new technology
- Flexibility in a fast-paced environment
- Ability to read, analyze, and interpret technical and legal documents
- Ability to write reports and business correspondence
- Ability to respond to inquiries or complaints from customers, claimants, and regulatory agencies
- Ability to present information to management and clients
- Ability to solve practical problems with limited standardization
- Ability to work in an office environment and regularly sit, walk, stand, talk, and hear
- Employment sponsorship is not offered for this opportunity
Benefits
Comp & perks- Competitive benefits package
- Generous medical, dental, and vision plans
- 401K retirement plans and company match
- Bonus potential for all positions
- Paid Time Off
- Paid holidays throughout the calendar year
- 100% support for continued learning
- Diverse and inclusive work environment