Workers' Comp Claims Specialist (Complex & Excess)

AGRiP (Association of Governmental Risk Pools); Atlanta (GA); On-site; USD 70,000 - 110,000; Full time

Job summary

Public Risk Innovation, Solutions, and Management (PRISM) is seeking a Workers' Compensation Claims Specialist. The role may be filled at Specialist or Senior Specialist level based on qualifications.

The position manages a caseload of excess workers' compensation claims, including complex and catastrophic matters, and provides oversight of TPAs and claims processes across PWC and EWC programs, reviewing medical care, reserves, and resolution strategies.

Qualifications

• Experience handling complex/excess workers' compensation claims.
• Ability to oversee TPAs and claims processes.
• Knowledge of medical management, reserves, and reinsurance in WC claims.

Responsibilities

• Manage a caseload of excess WC claims, including future medical and indemnity aspects.
• Provide oversight of TPAs and claims processes across WC programs.
• Review claims for appropriate medical care, reserves, reimbursement, and resolution.

Job description

Public Risk Innovation, Solutions, and Management (PRISM) is seeking a Workers' Compensation Claims Specialist. The role may be filled at Specialist or Senior Specialist level based on qualifications.

The position manages a caseload of excess workers' compensation claims, including complex and catastrophic matters, and provides oversight of TPAs and claims processes across PWC and EWC programs, reviewing medical care, reserves, and resolution strategies.