Workers' Compensation Claims Representative

This is a fully remote position, open to applicants in Texas.

📋 Description

• Oversee a designated caseload of medical-only and lost-time workers’ compensation claims from the initial report of injury to resolution.

• Make determinations regarding liability and compensability, assess losses, establish reserves, and negotiate settlements.

• Engage with claimants, policyholders, clients, medical providers, attorneys, appraisers, and other external parties.

• Conduct timely initial contacts and investigate new claims thoroughly.

• Verify coverage and obtain recorded statements as necessary.

• Maintain documentation of every conversation and action taken on a daily basis.

• Identify and resolve subrogation issues effectively.

• Start and terminate indemnity benefits accurately and in a timely manner.

• Complete jurisdictional forms with precision and promptness.

• Monitor ongoing medical treatment and request second medical opinions when required.

• Appropriately request surveillance as needed.

• Manage mail and diary tasks daily.

• Visit clients as necessary.

• Prepare for and conduct hearings.

• Communicate directly with clients.

• Compile reports and analytical data as requested by management.

⛳️ Requirements

• A valid Workers’ Compensation Adjuster license is required.

• A minimum of 2-3 years of experience in managing indemnity workers’ compensation claims is essential.

• High school diploma is necessary.

• Ability to adhere to instructions, procedures, and regulations.

• Strong attention to detail is crucial.

• Proficient written and verbal communication skills are required.

• Must be well-organized and capable of multitasking.

• Basic computer proficiency in MS Word, Excel, and Outlook is needed.

• Quick and accurate data entry skills are essential.

🏝️ Benefits

• Employee Stock Ownership Plan (ESOP), offering a significant retirement benefit to associates.

• Training programs designed to enhance the skills necessary for providing exceptional customer service.