Workers' Comp Claim Representative I - TX/OK

Entry-level professional claim handler responsible for handling medical only and indemnity benefits, determining compensability of claims, and negotiating settlements. Exercises discretion in determining claim reserves and facilitates return to work for injured employees.

Requirements

• Verifies workers' compensation coverage of employers and injured employees
• Determines compensability under workers' compensation by thorough investigation of the claim
• Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits
• Facilitates return to work for the injured employee
• Establishes timely and appropriate reserves based on the profile of the claim within given authority
• Documents specifics of claims with potential for subrogation recovery
• Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury
• Concludes and closes files following resolution of claims
• Negotiates settlements with attorneys or injured parties within given authority
• Works closely with manager on complex files or files above settlement/reserve authority
• Manages outside vendors to ensure cost containment efforts
• Establishes and maintains effective working relationships with all internal and external customers
• Stays abreast of changes in workers' compensation statutes, case law and rehabilitation efforts/advancements

Benefits

• Generous Paid Time Off
• 401k Matching
• Retirement Plan
• Health Insurance