What are the responsibilities and job description for the Workers Compensation Claim Analyst position at Optimal Inc.?
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. Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
Job Responsibilities:
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; manages reserve adequacy throughout the life of the claim.
Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle clams 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.
Skills Required:
Claims, Customer Service
Experience Required:
3-5 years of Illinois Workers' Compensation claims management experience
Education Required:
High School Diploma / GED
Full Onsite