Sr. Workers' Compensation Resolution Specialist (Hybrid/Remote)
Apply NowCompany: Public Risk Innovation Solutions and Management
Location: Folsom, CA 95630
Description:
Description
The Senior Workers' Compensation Resolution Specialist is responsible for managing and resolving complex workers' compensation claims with a strategic focus on mitigating exposure and ensuring fair and cost-effective resolutions for all parties. This role involves direct handling of settlement negotiations, developing settlement strategies, and collaborating with adjusters, specialists, legal teams, and other stakeholders to ensure claims are resolved in a timely and efficient manner that benefits the injured worker, the employer and the PRISM Programs in a fair and equitable approach. Additionally, the Resolution Specialist will be responsible for providing training and guidance to staff and members on claims processes, best practices, and strategies for reducing overall claims costs.
Requirements
Qualifications:
Skills and Competencies:
Work Environment:
The Senior Workers' Compensation Resolution Specialist is responsible for managing and resolving complex workers' compensation claims with a strategic focus on mitigating exposure and ensuring fair and cost-effective resolutions for all parties. This role involves direct handling of settlement negotiations, developing settlement strategies, and collaborating with adjusters, specialists, legal teams, and other stakeholders to ensure claims are resolved in a timely and efficient manner that benefits the injured worker, the employer and the PRISM Programs in a fair and equitable approach. Additionally, the Resolution Specialist will be responsible for providing training and guidance to staff and members on claims processes, best practices, and strategies for reducing overall claims costs.
Requirements
Qualifications:
- Education: Bachelor's degree or equivalent workers' compensation claims handling and negotiation experience. Certification in claims management or a related area is a plus.
- Experience:
- Minimum of 5-7 years of experience in workers' compensation claims handling, with at least 3 years focused on settlements or complex claims.
- Proven track record in settling and negotiating claims and navigating litigation processes.
- Familiarity with California Labor Code and case law as it pertains to workers compensation.
- Licenses/Certifications:
- Self-Insurance Plans certificate or ability to obtain within first six months of employment.
- Workers' Compensation Claims Administration (WCCA) certification is a plus.
- Workers' Compensation Claims Professional (WCCP) certification is a plus.
Skills and Competencies:
- Analytical Skills: Ability to analyze complex information, identify key issues, and make informed decisions.
- Communication Skills: Excellent written and verbal communication skills, with the ability to convey complex information clearly to various stakeholders.
- Negotiation Skills: Strong negotiation and settlement skills, with the ability to achieve favorable, fair and equitable outcomes.
- Legal Knowledge: In-depth understanding of California workers' compensation laws, regulations, and legal procedures.
- Interpersonal Skills: Ability to build and maintain relationships with internal and external parties.
- Organizational Skills: Exceptional time management and organizational abilities, capable of handling multiple claims simultaneously.
- Problem-Solving: Strong critical thinking and problem-solving abilities, with a focus on innovative solutions.
- Leadership Experience: Experience mentoring and training claims professionals.
- Strategic Thinking: Ability to develop and implement long-term strategies to mitigate claims costs and improve claims outcomes.
- Industry Knowledge: Up-to-date knowledge of industry trends, emerging risks, and best practices in large loss claims management
- Technical Skills: Proficiency in claims management software and Microsoft Office Suite
Work Environment:
- This role may be eligible for hybrid work model consisting of remote work and in-person work in our Folsom office, as well as occasional to frequent travel to attend hearings, mediations, or on-site settlement conferences as required.