WC Claims Representative - Charlotte, NC (Hybrid)

reputed company is a midsized U.S. domestic property and casualty insurance company with a strong history of financial performance. They are seeking two WC Claim Representatives to manage claims, communicate with various stakeholders, and ensure compliance with regulations.

Responsibilities

• Receives assigned lost time claims for investigation to determine coverage and compensability on claims with a short disability period of 8 weeks or less (could occasionally exceed 8 weeks)
• Processes claims which include the following activities: Making contacts, setting reserves, establishing file in MCS, evaluating exposure, and establishing initial and subsequent reserves on less severe claims with a general exposure of less than $25,000, and analyzing investigational data
• Makes timely payments and follow through to resolution
• May occasionally handle claims that exceed $25,000
• Documents claim files and maintains control of work through documentation or diary system
• Handle non-litigated claims only
• File state forms timely in accordance with statutory guidelines
• Collaborate with nurses and vendors on medical and disability management
• Prepare for and participate in claims review and settlement conferences
• Ensures compliance with company, state, and federal regulations

Skills

• Knowledge of workers compensation statutes, coverage, and case law
• Excellent written and verbal communication skills
• Working knowledge of medical treatment and terms as reputed company to medical only workers compensation claims
• Critical thinking skills to assess compensability of WC claim as it relates to the facts and law
• College degree preferred
• 1-3 years of workers comp claims experience preferred

Benefits

• Comprehensive health care plans
• Retirement savings plan with company match
• Discounted Employee Stock Purchase Program
• Tuition assistance and reimbursement programs
• 20 days of paid time off

Company Overview