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Workers Comp Claim Professional : Investigative Case Mgr Job - (hartford, connecticut) in Hartford, Connecticut For Sale

Type: Sales, For Sale - Private.

Job Opening IDxxxxBR
TitleWorkers Comp Claim Professional : Investigative Case Mgr
CountryUS
State/Region/ProvinceCT
CityHartford
Job CategoryClaim
Position TypeExperienced/Professional
Company InformationSolid reputation, passionate people and endless opportunities. Thats Travelers. Our superior financial strength and consistent record of strong operating returns mean security for our customers : and opportunities for our employees. You will find Travelers to be full of energy and a workplace in which you truly can make a difference.
Job SummaryUnder moderate supervision Investigate claims to determine compensability, and assert our customers legal rights to pay or deny the claim. This position does not lead others.
Primary Job Duties and ResponsibilitiesConduct initial investigation of claims to resolve compensability, coverage and offset issues on new notices Retain and manage assigned claims to conclusion if controverted or coverage is unconfirmed Reassign claims appropriately if non:controverted and coverage is confirmed Conduct complete investigation of questionable claims, including timely contact with appropriate parties. Develop and manage litigation strategy with Hearing Representative or Defense Counsel on litigated claims. Engage specialty resources as needed. Establish and update estimates to reflect exposure. Develop resolution strategies in order to negotiate and settle Claims Apply knowledge to determine causal relatedness of medical conditions. Interpret Workers Compensation policies and endorsements in coverage decisions. Customer Engagement Participate in Telephonic and/or onsite File Reviews Respond to inquiries : verbal and written Keeping injured worker apprised of claim status Other duties as assigned.
Job Specific and Technical Skills and CompetenciesAnalytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision:making. Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. Ability to effectively present file resolution to internal and/or external stakeholders. Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. : Thorough Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. Principles of Investigation: Intermediate investigative skills including the ability to take statements. Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. Mentors/coaches others to improve their investigative planning. Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. Medical knowledge: General knowledge of the nature and extent of injuries, periods of disability, and treatment needed. WC Technical: Intermediate ability to demonstrate understanding of WC Products and ability available resources and technology to resolve claims. Demonstrate a clear understanding and ability to work within jurisdictional parameters wit
Source: http://www.tiptopjob.com/jobs/xxxxxxxx_job.asp?source=backpage

State: Connecticut  City: Hartford  Category: Sales
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