To perform workers’ compensation claims adjudication and investigation. Responsible for all technical aspects of claim management for assigned including compliance with all established performance guidelines. Specific Duties - Properly investigate and handle all types of workers’ compensation files including lost time, litigation and long term exposure within predetermined claim-handling guidelines. - Initiate return-to-work discussions with the employer and effect return-to-work for the injured worker. - Establish timely and appropriate case reserves - Investigate and manage subrogation and negotiate settlements. - Use automated diary system to issue indemnity benefits and provide claim management. - Accurately calculate and pay wage loss and other benefits. - Assign rehabilitation and monitor costs and outcomes. - Document all action plans and evaluations for claim resolution. - Maintain organized electronic files. - Interact with clients to establish/improve communication and service capabilities. - Interact and communicate with state agencies, attorneys and other providers. - Address customer complaints and inquiries in an exemplary and professional manner. - Achieve specific performance outcomes related to quality and quantity of work as established by management. - Provide cost containment for individual claim and overall claim costs for account to achieve account profitability. - Define medical and rehabilitation payment parameters staff. May perform other functions as assigned.

The WC Claim Coordinator is a self-directed position responsible for providing a variety of support functions in a Claims environment. Specific Duties - Request information from or provide information to injured workers, employers, providers, attorneys, co-workers, state regulatory boards, 1st/3rd party claimants, and others as directed - Manage various avenues of loss reporting: e-mail, e-reporting, telephone, fax, or U.S. Mail - Input new claim loss data for multiple lines of business (Worker’s Compensation, Commercial Property, General/Auto/Excess Liability) into applicable claim systems - Research, verify and select proper active policy and coverages on new claims through review of policy/coverage information in policy databases - Initiate contact with clients or policy holders on applicable claims to triage losses and confirm facts of loss, request additional information and/or seek missing critical data elements - Manage daily distribution of new claims to ensure equitable examiner workload and effective customer service - Ensure timely filing of regulatory documents via EDI (Electronic Data Interchange); submit applicable claims to Index Bureau Reporting (ISO) and document files as applicable - Handle incoming phone calls and/or electronic/written inquiries from Clients, Claimants, Providers and Agents/Brokers relating to questions or problems associated with claims - Provide additional levels of management and claim department operational support to include payment review/approval/input and complete scheduled or special project work as needed - Maintain organization of claim files with accurate and timely documentation of work activity - Manage workload via system diary activity - Provide professional customer service to all internal and external customers May perform other functions as assigned.