Negotiates settlements with attorneys or injured parties within given authority at the earliest possible point to bring cases to final disposition.
Works closely with manager on complex files or files above settlement/reserve authority.
Manages outside vendors to ensure cost containment efforts.
Establishes and maintains effective working relationships with all internal and external customers.
Stays abreast of changes in workers’ compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.
Administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.
Exercises independent judgment to settle cases prior to mediation or litigation.
Actively participates in agent/client relationship management.
Assists in mentoring team members.
EDUCATION AND EXPERIENCE
Relevant combination of education and experience may be considered in lieu of degree.
Bachelor’s degree in a related field. Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.
Three (3) years of experience in a workers’ compensation claims environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing workers’ compensation claims. Experience of handling claims in multiple jurisdictions preferred. Bilingual skills preferred.
OR
One (1) year of AF Group Claims Representative I experience that includes handling of difficult or complex claims.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
OTHER SKILLS AND ABILITIES
Ability and proficiency in the use of computers and company standard software specific to position.
Knowledge of medical and legal terminology related to the work.
Knowledge of workers’ compensation laws and regulations, including jurisdictional laws.
Effective oral and written communication skills.
Effective customer service skills.
Ability to negotiate, build consensus and resolve conflict.
Ability to manage multiple priorities and meet established deadlines.
Attention to detail and analytical skills.
Ability to work independently as well as within a team.
Ability to make independent decisions.
Ability to solve complex problems.
ADDITIONAL INFORMATION
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment.
PAY RANGE
Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not the standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $56,700 and $94,900.
We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
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