Job SummaryProcess Workers Compensation Medical and Indemnity Claims, monitor Workers Compensation cases and direct attorney and outside vendors assigned to these claims.
Essential Job Functions- Confirm coverage and policy information.
- Establish proper loss reserve, negotiate loss settlement (when applicable) and bring cases to resolution.
- Maintain control of outside vendors/attorneys and their expenses by directing assignments to them and limiting their scope to maximize cost effectiveness while minimizing delays in claims handling. Such vendors/attorneys must not be used unless pre-approved by the department manager.
- Maintain compliance with Workers' Compensation procedure and requirements established by regulatory authorities.
- Pursue Workers' Compensation liens and subrogation when appropriate.
- Maintain compliance with claims practice rules and internal instructions.
- Keep manager advised of significant developments in claims.
- Answer correspondence and inquiries promptly from brokers/agents, insureds, claimants, doctors, attorneys, outside vendors, TMA employees, etc.
- Responsible for complying with proper internal controls as necessary to conduct job functions and/or carry out responsibilities and/or administrative activities at Company.
Qualifications- College Degree Preferred
- 5 to 10 years of experience handling Workers' Compensation claims for a major insurance carrier
- Must have applicable state licensing or the ability to obtain.
- Knowledge of Workers' Compensation policy coverages
- Knowledge of coding related to claims technical matters
- Knowledge of legal, medical terms and meanings, civil and agency laws and related fields which may come within the purview of Workers' Compensation claims
- Ability to negotiate settlement/resolution of claims in a timely and reasonable fashion
- Proficient in Microsoft office
- Good oral and written communication skills
Salary range $115,000 to $120,000. Ultimate salary offered will be based on factors such as applicant experience and geographic location. Our company offers a competitive benefits package and bonus eligibility on top of base.
TMA believes the perfect candidate is more than just a resume. If you don't meet every single requirement, but are still interested in the job, we encourage you to apply.Benefits:We offer a comprehensive benefit package, which includes a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities.
