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Workers' Compensation Claims Representative

Remote · Philippines Full-time

Job Description:

  • Determine compensability and/or coverage issues for loss time workers' compensation claims.
  • Effectively manage a caseload of loss time claims from numerous jurisdictions.
  • Negotiate and direct settlements under management's review.
  • Gather medical and factual evidence to determine compensability.
  • Direct outside investigation and handle litigation files within given authority.
  • Coordinate and maintain contact with claimants and/or their attorneys, outside investigators, and rehabilitation personnel as well as routine contact with insureds, account liaisons and medical providers.

Requirements:

  • A minimum of 3 years of insurance carrier experience required.
  • Experience handling claims in multiple jurisdictions, including: TN, GA, NC, SC, AL.
  • Bachelor's degree required.
  • Carrier experience preferred.
  • Experience in handling lost time or litigated claims.
  • Familiarity with medical terminology.
  • Demonstration of strong organizational, problem solving, negotiation, and conflict resolution skills.
  • Excellent verbal and written communication skills needed.

Benefits:

  • Medical (PPO/HDHP), vision, disability, and life insurance.
  • Enhanced dental plan with orthodontia coverage in addition to a standard plan.
  • Generous PTO plan for all benefit-time eligible employees.
  • Paid company holidays and 4 floating holidays.
  • Paid parental leave.
  • Employee Retirement Savings Plan/401(k) with company match and immediate vesting.
  • Education Assistance Program that offers 100% upfront tuition reimbursement after 6 months of service for approved degree programs.
  • Service Recognition Program that provides a monetary award to be used toward a vacation every 5 years of employment.
  • Wellness Initiatives that include Fitness Center and Weight Watchers Reimbursement programs.
  • Voluntary benefits that include accident, critical illness, and hospital indemnity.
  • Employee discount and rewards program on travel, tickets, electronics, home, and more.

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