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Property Casulty

Workers' Compensation Claims Advocate

Purpose:
To work as an advocate for our clients with the respective carriers claims examiner handling the claim and ensure that the claims are being handled in a timely and cost effective manner. Accomplish this by striking a balance between taking an assertive and aggressive position on the claims examiners action plan and reserving practices while maintaining a respectful relationship with the claims personnel.
The Claims Advocate must promote the best interests of the client without alienating the claims examiner or appearing to be unconcerned with the welfare of the injured worker. In addition sometimes the claims advocate will need to educate and direct the client’s expectations so that they are in line with a reasonable claims outcome.

Essential Functions & Responsibilities:

  • Coordinate and oversee claims management strategies on reserving, settlement and closure for designated clients
  • Obtains clients claims data from past and existing carriers
  • Negotiate claim closings and changes in reserves for positive client outcome
  • Maintain an internal active diary system of claims being managed
  • Depending on the client, their needs and their size, conduct quarterly or semiannual claims reviews in person, teleconferencing, or via telephone\
  • Provides individual claims analysis reports that include a historical summary, current status and next step action plan
  • Create 5-10 year historical claim, frequency and severity rate summaries for reach client
  • Conduct unit statistical review meetings and project future experience modifications
  • Attends new business calls with producers when necessary
  • Proactively identify claim trends and communicate them to the producers
  • Act as a trusted advisor and resource for clients by answering questions regarding workers compensation claim laws, rules and coverage.
  • Occasional travel necessary

Required Qualifications and Experience

  • 4-7 years of workers compensation claims experience with an insurance carrier or TPA
  • Strong written and verbal communication skills
  • Comfortable working knowledge of MS Word, Excel and PowerPoint
  • Ability to create effective presentation documents for claims analysis reports
  • Possess a strong ability to work independently and effectively manage time

Qualifications and Experience:

  • 4-7 years of workers compensation claims experience with an insurance carrier or TPA
  • Strong written and verbal communication skills
  • Comfortable working knowledge of MS Word, Excel and PowerPoint
  • Ability to create effective presentation documents for claims analysis reports
  • Possess a strong ability to work independently and effectively manage timeWorker

Posted 07/19/2017.