Must have TEXAS workers' compensation license and seeking 5 years experience in lost time work comp claims for TEXAS jurisdiction. POSITION SUMMARY: Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of 110 to 160 workers' compensation files, including very complex claims.* Initiates and conducts investigation in a timely manner.* Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.* Manages medical treatment and medical billing, authorizing as appropriate.* Communicates with claimants, providers and vendors regarding claims issues.* Computes and set reserves within Company guidelines. Maintains diary system for case review and documents file to reflect the status and work being performed on the file.* Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.* Adheres to all Company policies and procedures.* Conducts file reviews independently.* Other duties as assigned. * Essential job function. EQUIPMENT OPERATED/USED: Computer, 10-key, fax machine, copier, printer, and other office equipment.
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