Sr Claims Representative Workers Compensation

Sr Claims Representative Workers Compensation

The James Allen Companies Inc.

Position Summary: Sr Claims Representative Workers Compensation

This position handles workers compensation claims across multiple jurisdictions. This includes assessing claim
coverage and compensability, including reserving, investigating, evaluating, and effectively resolving all
assigned claims in a timely manner according to company and regulatory guidelines. Provides a high level of
customer service to internal and external business partners. Potential opportunity to expand experience and
learn multiple lines of coverage.
Primary Responsibilities:
• Review and evaluate claim reserves to ensure that the respective reserve properly reflects the potential
exposure
• Investigate claims, which may include meeting with Insureds and witnesses, and obtaining statements,
records, and other evidentiary materials
• Provide proper documentation and reporting of investigation and claims handling activities
• Negotiates, including through mediation, arbitration, or other court-supervised settlement efforts,
settles, and resolves claims with claimants, insureds, and their lawyers; provides appropriate claims
resolution documents
• Maintain a working knowledge of regulatory and jurisdictional requirements
• Provides direction to and management of defense counsel, independent adjusters and other third
parties retained to assist in a particular claim
• Other duties as assigned
Qualifications:
• Minimum of 5 years of experience with the following:
o Claims Investigation – Statements, authorizations, retention of qualified experts and counsel
o Claims Administration – Reports, review and set reserves, compliance knowledge of laws and
procedures, including lost time, serious injury, and litigated claims
o Litigation management – work with defense counsel and experts to resolve litigated claims
• Knowledge of coverage, negligence principles, investigation and negotiation techniques
• Experience in any or all of the following states helpful: MN, WI, IL, IA, SD
• Ability to obtain and maintain state adjusting licenses, as needed
• Must be service-oriented, with the ability to provide prompt, efficient, and effective claims and customer
service
• Ability to communicate clearly and effectively with our customers, claimants, opposing counsel, defense
counsel, and members of the public
• Ability to manage and organize workload of multiple tasks simultaneously
• Excellent judgement, negotiation, and decision making skills
• Must be able to travel between different off-site locations or overnight in an expeditious manner

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