Claims Representative - Lost Time Workers' Compensation

Gwinnett County
Competitive salary with attractive benefits package
Mar 07, 2018
May 06, 2018
Job Type
Full Time
Career Level
Not Specified

LOST TIME CLAIMS REPRESENTATIVE: The Lost Time Workers’ Compensation Claims Representative is responsible for quality handling and resolution of complex workers’ compensation claims in a timely, professional manner with emphasis on providing quality service while controlling expenses. Position routinely handles claims involving complex return-to-work issues, complex injuries and litigated workers’ compensation issues.


· Investigate and process Georgia workers’ compensation claims from assignment to conclusion.

· Interview claimant and witnesses to gather pertinent information.

· Work with the injured worker and telephonic case manager to medically manage the claim from initial medical to reviewing and evaluating on going medical information.

· Provide consistent customer service to the client and injured worker through timely responses to all inquiries, telephone calls and emails while delivering on service commitments.

· Review incoming mail daily; respond as needed to bring the claim to a prompt conclusion, seeking supervision as needed.

· Evaluate and set reserves for ultimate exposure.

· Timely filing of Board forms.

· Timely filing of wage loss benefits.

· Ensure accurate and timely entry of required data information.

· Work directly with employers to facilitate a return to work either to a full-time or modified duty basis.

· Maintain a current diary on outstanding claims.

· Provide direction and guidance to defense attorneys and other experts while controlling costs.

· Meet or exceed specific objectives for service standards, quality, reserving standards, expense controls and other measurable performance items.

· Perform other duties as assigned.



· Bachelor’s degree or equivalent work experience.

· 3-5 years’ experience as a claim representative or equivalent.

· Excellent communication and negotiation skills.

· Strong verbal and written skills are required;

· The ability to multi-task and prioritize is needed; strong organization and time management skills required.

· Valid Georgia adjuster license and/or Georgia Certified Workers’ Compensation Professional.

· Knowledge of workers’ compensation law.

· Computer proficiency, working knowledge of Microsoft Office Products.

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