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Crum & Forster · 1 day ago

Senior Specialist - Workers Compensation - PA or MN Jurisdiction

United States

Full-time

Remote

Mid, Senior Level

$56K/yr - $105K/yr

3+ years exp

Crum & Forster is a prominent insurance company with a legacy dating back to 1822, recognized for its specialty and standard commercial lines insurance products. They are seeking a Senior Specialist in Workers Compensation who will examine claims data, conduct investigations, and manage claims within assigned authority, specifically for PA or MN jurisdictions.

Commercial InsuranceHealth CareInsuranceRisk Management

Growth Opportunities

Responsibilities

Must be well versed in the following state act jurisdictions: PA, MN, IN, and or IL

Receives lost time and complex medical only assignments. Verifies and determines applicability of coverage. Initiates 24-hour contact with employer, employee and 48-hour contact with attending physician

Handles catastrophic claims with supervisory oversight

Conducts telephone investigations as required by company claims handling manual and procedures

Evaluates and adjusts claims within the limits of authority

Consults with Claim Manager on those claims where assistance and consultation is needed

Makes assignments to nurse case management when indicated, monitoring their billing and performance

Sets reserves for anticipated exposure up to authority limits

Completes mandatory Reserve Worksheets. Establishes reserves requiring complex analysis with lifetime pharmacy and cost inflation

Coordinates return to work (RTW) and sets target dates

Maintain diaries on maximum three (3) month intervals

Documents files in the claims system

Reviews medical bills for causal relationship, medical bill charges for appropriateness and approves payments

Adheres to special account handling (SHI) instructions

Attends account meetings by telephone and in-person

Manages litigation on the files

Qualification

Workers Compensation ClaimsPA Jurisdiction ExperienceMN Jurisdiction ExperienceMicrosoft OfficeForeign LanguageOrganizational SkillsTime ManagementVerbal CommunicationWritten Communication

Required

Must be well versed in the following state act jurisdictions: PA, MN, IN, and or IL

College degree, B.A. or equivalent experience

Minimum of 3 years' experience handling workers compensation claims

Strong organizational skills

Good time management skills

Excellent verbal and written communication skills are essential

Strong aptitude and knowledge of Microsoft Office programs and the ability to quickly learn new programs

Will abide by departmental policies and procedures, including authority levels, to comply with C&F's risk management controls

Preferred

Foreign language communications a plus

Benefits

Competitive compensation package

Generous 401K employer match

Employee Stock Purchase plan with employer matching

Generous Paid Time Off

Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing

A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path

A dynamic, ambitious, fun and exciting work environment

We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community