Workers Compensation Plant Rep II

Optimal; Claycomo (MO); On-site; USD 60,000 - 85,000; Full time

Job summary

Optimal is seeking a Plant-based Workers' Compensation Claims Handler in Missouri. The role emphasizes excellent customer service, quality claims handling, and loss cost management on-site at the plant.

Requirements include 3-5 years of Missouri WC claims adjusting experience and a High School Diploma or GED; a Bachelor's degree is preferred. The position involves complex claim analysis, reserves, and coordination with vendors to ensure cost-effective resolutions.

Qualifications

• Missouri workers' compensation claims experience required.
• Investigate and gather information to determine exposure on the claim.
• Ability to handle full caseload with higher severity claims.

Responsibilities

• Analyze and process complex workers' compensation claims.
• Investigate information and coordinate with claimants, clients, and vendors.
• Calculate and assign reserves and pay benefits within authority.
• Prepare state filings within statutory limits.
• Coordinate vendor referrals for investigation and litigation.
• Maintain proper claim documentation and coding.

Skills

Workers' Compensation

Education

High School Diploma / GED

Bachelor's Degree

Job description

Position Description

Primary Workers' Compensation Claims Handler at the Plant with a focus on excellent customer service, quality claims handling, and loss cost management. Plant-based position

Skills Required

Workers' Compensation

Experience Required

3-5 years of Missouri Workers' Compensation Claims Adjusting experience

Education Required

High School Diploma / GED

Education Preferred

Bachelor's Degree

Additional Information

Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim Ability to handle a full case load, with proven ability to handle cases of increased severity. Workers' Compensation Lost Time claim handling experience Manage claims through well-developed action plans to ensure timely and cost-effective resolutions. Calculate and assign timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle clams within designated authority level. Prepare necessary state fillings within statutory limits. Coordinate vendor referrals for additional investigation and/or litigation management. Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. Manage claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. Report claims to the excess carrier. Communicate claim activity and processing with the claimant and the client. Ensure claim files are properly documented, and claims coding is correct. Refer cases as appropriate to supervisor and management.
Fully Onsite.