• Investigate and manage claim files to help individuals and businesses prevail after a claim • Handle higher complexity Workers’ Compensation claims requiring timely investigations, financial accuracy, effective benefit oversight, appropriate file disposition, and adherence to statutory guidelines • Plan, recommend, and execute the investigation and disposition of claims consistent with corporate claim standards policies and procedures, and statutory, regulatory and ethics requirements • Manage caseload/claims within established performance standards • Establish and maintain effective relationships with customers, gaining their trust and respect • Be responsible for successfully managing Workers' Compensation claims • Fully engage your exceptional verbal and numerical critical thinking skills; gather information, apply reasoning and draw appropriate conclusions to make sound decisions • Plan recommend, reserve and execute the investigation, valuation, disposition and settlement of claims • Achieve fair, equitable and timely claim dispositions • Properly assess the indemnity, medical and expense exposure of assigned claims • Set reserves accurately and in a timely manner • Accurately resolve coverage and compensability issues • Plan, organize and establish priorities, determine realistic completion dates • Develop technical and jurisdictional expertise • Maintain current knowledge of claim loss cost containment initiatives and use them appropriately and consistently with company practices and procedures • Identify and initiate mitigation, subrogation and other recovery opportunities on assigned claims • Identify fraud indicators and initiate investigation on assigned claims • Apply general mathematical knowledge or financial analysis to achieve results