What are the responsibilities and job description for the Senior Claims Expert position at Employers?
Job Overview
As a Senior Claims Adjuster I, you will play a key role in the timely and accurate management of workers' compensation claims. This includes handling medical and indemnity benefits, addressing litigation and complex issues, and managing moderate to high exposure cases.
Key Responsibilities
- Complete initial contacts to obtain necessary information, verify coverage, determine compensability, and develop a plan of action.
- Analyze case facts to establish timely and accurate reserves using knowledge and experience with medical disabilities and related costs.
- Collaborate with Corporate Claims to evaluate and mitigate high exposure losses.
- Provide timely and appropriate customer service within established best practices.
- Evaluate and pay benefits in compliance with statutory and company procedures and guidelines.
- Manage or coordinate medical treatment to continue to move the claim forward.
- Review and analyze litigation and legal issues.
- Complete detailed settlement analysis and recommend an appropriate settlement value.
- Regularly review caseload and take action to guide claims efficiently and effectively to closure.
