Claims Examiner Workers Compensation - Bartlesville
1 month ago
Claims Examiner Workers Compensation +
Job summary
To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations , industry best practices and specific client service requirements; and to identify subrogation of clams.- Analyzes
- Negotiates settlement
- CALCULATES AND ASSIGNS TIMELY AND APPROPRIATE RESERVES TO CLAIMS ; MANAGES RESERVE ADEQUACY THROUGHOUT THE LIFE OF THE CLAIM.
This includes investigating gathering information determining exposure on claim managing through well-developed action plans appropriate timely resolution negotiating settlement designated authority calculates approves timely claim payments adjustments settles within designated level prepares necessary state fillings statutory limits manages litigation process ensures timely cost-effective clams resolution coordinates vendor referrals additional investigation litigation management uses appropriate cost containment techniques including strategic vendor partnerships reduce overall cost clams clients manages claim recoveries including subrogation Second Injury Fund excess recoveries Social Security Medicare offsets reports exess carrier responds requests directions professional timely manner communicates claim activity processing with clamant client maintains professional client relationships ensures file properly documented coding correct refers cases supervisor management performs other duties assigned supports organizations quality program travels required .
Job description
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