Workers Compensation Claims Specialist
1 month ago
Job Summary
We are seeking a highly skilled Workers Compensation Claims Consultant to join our team at CNA. As a key member of our claims team, you will be responsible for managing complex investigations of claims, determining liability and compensability, and implementing effective resolution strategies.
Key Responsibilities
- Manage highly complex investigations of claims, including coverage issues, liability, and damages.
- Determine if a major claim should be settled or litigated and implement an appropriate resolution strategy.
- Effectively manage loss costs and claim expenses.
- Manage all types of investigative activity or litigation on major claims, including the posting of appropriate reserves in a timely manner.
- Negotiate highly complex settlement packages and authorize payment within scope of authority.
- Coordinate third-party recovery with subrogation/salvage unit.
- Make recommendations on claims processes and resolution strategies to management.
- Analyze claims activities and prepare and present reports to management and other internal business partners and clients.
- Work with attorneys, account representatives, agents, doctors, and insureds regarding the handling and/or disposition of highly complex claims.
- Keep current on state/territory regulations and issues, industry activity, and trends.
- Provide guidance and assistance to less experienced claims staff and other functional areas.
Requirements
- Advanced technical and product-specific expertise, claims resolution skill, and knowledge of insurance and claims principles, practices, and procedures.
- Strong communication, negotiation, and presentation skills.
- Advanced analytical and problem-solving skills, with the ability to manage and prioritize multiple projects.
- Ability to deal with ambiguous situations and issues.
- Creativity in resolving unique and challenging business problems.
- Knowledge of Microsoft Office Suite and other business-related software.
- Ability to adapt to change and value diverse opinions and ideas.
- Ability to manage and prioritize multiple projects.
- Ability to evaluate claims based on a cost-benefit analysis.
- Ability to fully comprehend complex claim facts and issues and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
- Ability to implement strategies with a proactive long-term view of business goals and objectives.
Education and Experience
- Bachelor's degree or equivalent experience.
- Typically a minimum eight years of claims experience.
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