What are the responsibilities and job description for the Workers Compensation Plant Rep III position at Optimal Inc.?
*Position is Fully onsite
Position Description:
- Primary Workers' Compensation Claims Handler at the Plant with a focus on excellent customer service, quality claims handling, and loss cost management. Plant-based position with hybrid work schedule to be considered.
Skills Required:
Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim
- Ability to handle a full case load, with proven ability to handle cases of increased severity.
- Workers' Compensation Lost Time claim handling experience
- Manage claims through well-developed action plans to ensure timely and cost-effective resolutions.
- Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim.
- Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle claims within designated authority level.
- Prepare necessary state fillings within statutory limits.
- Coordinate vendor referrals for additional investigation and/or litigation management.
- Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
- Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
- Report claims to the excess carrier.
- Communicate claim activity and processing with the claimant and the client.
- Ensure claim files are properly documented, and claims coding is correct.
- Refer cases as appropriate to supervisor and management
Skills Preferred:
- Excellent oral and written communication skills.
- PC literate, including Microsoft Office products.
- Analytical and interpretive skills.
- Strong organizational skills.
- Good interpersonal skills.
- Excellent negotiation skills.
- Ability to work in a team environment.
Experience Required:
- 3-5 years of Illinois Workers' Compensation claims management experience
Education Required:
- College degree and 3-5 years of Illinois claims management experience or equivalent combination of education and experience preferred.
- High school diploma and 3-5 years related Illinois claims experience accepted
