Senior Workers' Compensation Claims Specialist
State Auto
- Rocklin, CA
- $122,400 per year
- Permanent
- Full-time
- Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain-of-custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners. Refers to claim to subrogation group or Special Investigations Unit as appropriate.
- Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim.
- Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
- Coordinates the litigation activities associated with assigned claims to ensure a timely and cost-effective resolution; attends trials as a representative of the company.
- Acts as senior technical professional on team, assisting team members with escalated issues. Mentors and trains new team members. Participates in Quality Review process.
- Participates in conducting Suit Committees, Roundtables, Arbitrations, Mediations, field investigations and may assist in conducting closed file reviews.
- Performs other duties as assigned.
- Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required.
- Leadership ability and demonstrated time management skills to delegate work appropriately and organize resources effectively.
- Demonstrates an advanced knowledge of workers' compensation claims case handling practices, legal liability, general insurance policy coverage, and the state`s tort laws as normally acquired through a bachelor`s degree (or equivalent training) plus 3 to 5 years directly related work experience.
- Required to obtain and maintain all applicable licenses.