Claims Workers Compensation Loss Time Representative (remote)

If you're excited about this role but don’t meet every qualification, we still encourage you to apply! At Grange, we value growth and are committed to supporting continuous learning and skill development as you advance in your career with us.

Summary: This role is responsible for investigating, evaluating and negotiating settlement of WC Loss Time claims while overseeing all vendor and legal activities.

1. Pursuant to WC line of business strategies and good faith claim handling practices; investigates, negotiates and resolve/settle (within authorized limits) assigned claims.
2. Establish and maintain positive relationships with internal and external customers providing excellent customer service to include timely initial and follow up communication. Compliance with all special handling commitments within the Account Stewardship program.
3. Ability to effectively manage litigated and large catastrophic claims.
4. Maintain file notes outlining actions taken and plan of action for future handling.
5. Effectively manage loss severity through utilization of medical cost management resources and pursuit of early return to modified and full duty work.
6. Follow through on all special claim handling agreements for Account Stewardship program.
7. Maintain work activities to ensure proactive claim resolution.
8. Establish appropriate initial reserves and revise consistent with reserve best practices.
9. Timely completion of all required state reporting.
10. Identify, investigate and pursue claims involving subrogation and potential fraud.
11. Manage all vendor activities and expense payments.
12. Maintain current knowledge of Workers’ Compensation laws and claim handling procedures in designated states.