Apply on Employer Site

LWCC · 1 month ago

Senior Claims Representative (Workers' Compensation)

Baton Rouge Metro

Full-time

Hybrid

Mid, Senior Level

4+ years exp

LWCC is a Champion of Louisiana and is dedicated to excellence in execution from underwriting to compassionate care of injured workers. The Senior Claims Representative will investigate, evaluate, and manage assigned workers' compensation claims, ensuring timely resolutions and settlements while serving as a resource and mentor to department members.

Employee BenefitsHealth InsuranceInsurance

Responsibilities

Serve as dedicated claims representative to handle special customer service requirements for assigned accounts

Proactively manage litigated claims with in-house legal or outside counsel with focus on timely resolution and/or settlement

Evaluate and settle all claims with settlement potential within increased authority limits and present claims exceeding authority levels to executive claims committee for resolution of large exposure claims

Responsible for investigating and determining coverage, compensability, and subrogation and second injury fund potential, as well as resolving unique coverage issues where coverage may involve multiple carriers or claims involving employers’ liability exposure

Manage occupational disease claims and any other claims involving extraordinary claim issues, to include high IWIS claims and other high exposure claims

Manage personal caseload effectively to mitigate exposure within controllable claim cost objectives

Develop cost containment strategies for large claims and make recommendations for productive case outcomes

Document claim files in accordance with quality review standards and complete reinsurance reporting on high exposure claims

Approach job in a conscientious, mature fashion demonstrating a sense of responsibility. Exhibit an ethical manner of conduct and keep sensitive information confidential. Demonstrate a willingness to contribute whatever is necessary to get the job done

Investigate larger more complex workers’ compensation claims following sound claims handling techniques in accordance with company claim philosophy and quality assurance standards

Establish and maintain appropriate file reserves with increased authority limits that accurately reflect file exposure in accordance with company file reserving procedures

In addition to continuous communication with injured workers, medical providers, plaintiff attorneys and defense attorneys, also provides an appropriate level of customer service to policyholders and agents and promptly responds to resolve complaints or claim problems

Resource for and mentor to less experienced claims representatives

Provides other job duties as dictated by office circumstances

Qualification

Workers' Compensation ClaimsLouisiana Workers' Compensation Adjuster LicenseClaims InvestigationClaims SettlementCost Containment StrategiesAnalytical SkillsCustomer ServiceEffective CommunicationNegotiation SkillsProblem SolvingTime Management

Required

Bachelor's degree and four years handling workers' compensations claims. OR High School Diploma/GED with eight years of insurance claims handling experience, four of which being workers' compensation claims

Active Louisiana Workers' Compensation Adjuster License required prior to start or obtained within seven (7) business days after start date

Minimum of two years as a Claims Representative strongly preferred

Strong character

Alignment with company values, mission, and vision

Trustworthy and honest

Decisive

Curious and persistent

Commitment to accountability

Passion for innovation

Willingness to learn

Adaptive to changing (tolerance for ambiguity)

Desire to collaborate to achieve corporate goals