Worker's Compensation Representative

Wisconsin Municipal Mutual Insurance Company; Madison (WI); Ibrido; USD 60.000 - 85.000; Tempo pieno

Descrizione del lavoro

Wisconsin Municipal Mutual Insurance Company seeks a Workers’ Compensation Representative to oversee claims from initial report to resolution. You will investigate liability, ensure timely processing, and protect organizational interests while supporting excellent member service.

Ideal candidates have 3+ years of WC claims experience, knowledge of Chapter 102, and strong communication skills. This hybrid/remote role includes occasional in-person meetings and travel within Wisconsin.

Competenze

• Bachelor’s degree or equivalent combination of education and relevant work experience.
• 3+ years of workers’ compensation claims experience (3–5 years preferred).
• Experience handling medical-only, lost-time, and Medicare-related claims.
• Knowledge of Wisconsin Department of Workforce Development requirements and Chapter 102.
• Strong written and verbal communication skills, with the ability to explain claim information clearly.
• High attention to detail, sound judgment, confidentiality, and ability to manage multiple priorities.

Mansioni

• Investigate workers’ compensation claims to assess liability, eligibility, and next steps.
• Manage claims from initial report through resolution.
• Authorize and document claim payments accurately and in accordance with requirements.
• Maintain compliance with federal, state, and municipal regulations, including Wisconsin Chapter 102.
• Prepare and submit required reports to regulatory agencies.
• Serve as a professional contact for claimants, employers, medical providers, attorneys, vendors, and internal team members.
• Negotiate settlements and support dispute resolution with fairness and sound judgment.
• Utilize claims management tools including Origami Risk and Verisk Claim Search; leverage MS Office applications.
• Contribute to process improvements, system enhancements, and operational efficiencies.

Conoscenze

Communication skills

Analytical thinking

Time management

Verbal/written communication

Formazione

Bachelor’s degree or equivalent

Strumenti

Origami Risk

Verisk Claim Search

Microsoft Office

Descrizione del lavoro

Location: Wisconsin-based hybrid/remote role with occasional in-person meetings, trainings, and member-related travel

FLSA Status: Exempt

WMMIC

At Wisconsin Municipal Mutual Insurance Company (WMMIC), we believe how we work is just as important as what we do. We are built on trust, respect, accountability, and a shared commitment to excellence in service to our municipal members.

We value people who act with honesty and integrity, treat others with respect, follow through on commitments, and stay open to new ideas and diverse perspectives. If you are a thoughtful claims professional who thrives in a collaborative, service-focused environment, we encourage you to apply.

About the Role

The Worker’s Compensation Representative manages workers’ compensation claims from initial report through resolution. This role combines claim investigation, regulatory knowledge, careful documentation, and empathetic communication to support injured workers, members, medical providers, attorneys, vendors, and internal stakeholders.

You will help ensure claims are handled fairly, accurately, and timely while protecting organizational interests and supporting WMMIC’s commitment to exceptional member service.

What You’ll Do

• Investigate workers’ compensation claims to assess liability, compensability, eligibility, and appropriate next steps.
• Manage claims from initial report through resolution, including medical-only, lost-time, Medicare-related, and complex claims.
• Authorize and document claim payments accurately and in accordance with applicable requirements.
• Maintain compliance with federal, state, and municipal regulations, including Wisconsin workers’ compensation requirements and Chapter 102.
• Prepare and submit required reports to regulatory agencies.
• Serve as a professional point of contact for claimants, employers, medical providers, attorneys, vendors, and internal team members.
• Negotiate settlements and support dispute resolution with fairness, professionalism, and sound judgment.
• Use claims management and reporting tools, including Origami Risk, Verisk Claim Search, and Microsoft Office applications.
• Contribute to process improvements, system enhancements, and operational efficiencies.

What We’re Looking For

• Bachelor’s degree or equivalent combination of education and relevant work experience.
• At least three years of workers’ compensation claims experience; three to five years preferred.
• Experience handling medical-only, lost-time, and Medicare-related workers’ compensation claims.
• Knowledge of Wisconsin Department of Workforce Development requirements and Wisconsin Chapter 102.
• Strong written and verbal communication skills, with the ability to explain claim information clearly and professionally.
• High attention to detail, sound judgment, confidentiality, and the ability to manage multiple priorities.
• Analytical problem-solving skills and comfort working with claims systems, reporting tools, and Microsoft Office applications.
• Experience with Origami Risk and Verisk Claim Search preferred.
• Experience with auto liability, bodily injury, general liability, litigation, municipal liability, or employment practices liability is a plus.
• Valid driver’s license, current vehicle insurance, reliable transportation, and ability to travel overnight as needed.

This is a Wisconsin-based hybrid/remote position. The role is primarily remote, with in-person attendance expected for scheduled office meetings, trainings, conferences, and member-related travel. The position requires regular computer and telephone use, frequent communication with members and stakeholders, occasional lifting of items up to 10 pounds, and the ability to work effectively in time-sensitive situations.

Why Join WMMIC?

At WMMIC, you will be part of a mission-driven organization that puts members first, values ethical conduct, and supports continuous improvement. You will work with a team that takes pride in doing excellent work while treating people with respect, dependability, and care.

Equal Opportunity Employer

WMMIC is an equal opportunity employer. We are committed to providing reasonable accommodations to enable qualified individuals with disabilities to perform the essential functions of the role.