Manage a caseload of multi-state workers’ compensation claims, including indemnity, employer’s liability, and subrogation exposures
Conduct initial claim investigation, including coverage verification, compensability determination, and timely contact with involved parties
Communicate with injured workers, employers, medical providers, attorneys, and other stakeholders to support claim resolution
Set and manage reserves to ultimate probable cost within established authority levels
Ensure timely delivery of benefits and required notices in accordance with jurisdictional requirements
Coordinate return to work efforts in alignment with medical guidance and employer programs
Manage litigation, including directing defense counsel and attending hearings or depositions as needed
Negotiate settlements with injured workers, attorneys, and other parties
Identify and pursue subrogation opportunities and manage third party recoveries
Review medical and expense bills for accuracy, causation, and appropriateness
Maintain accurate and timely documentation within the claims system
Prepare claim status reports and participate in claim review meetings
Assign and coordinate nurse case management resources when appropriate
Collaborate with leadership on complex claims requiring additional support or escalation

Experience handling workers’ compensation claims required
2 to 5 years of relevant claims experience or equivalent experience required
Strong understanding of workers’ compensation laws, claims processes, and jurisdictional requirements
Experience managing indemnity claims, litigation, and claim resolution strategies
Strong analytical skills, decision making ability, and attention to detail
Ability to manage multiple claims in a fast paced environment
Strong organizational and time management skills
Proficiency with Microsoft Office and claims management systems
Ability to work independently with limited supervision
Litigation experience beneficial
High school diploma required, bachelor’s degree beneficial
Relevant state licensing beneficial or ability to obtain as required

Claims Analyst II

Key skills