Claims Representative - Lost Time Workers' Compensation
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.