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Sr. Workers' Compensation Claims Rep - Field

:
2018-1870
:
1
:
US-IA-Cedar Rapids
:
10/16/2018
:
Claims
:
50%
Yes
 
 

Overview:

UFG offers you an award-winning workplace and a trustworthy, financially stable company. While we’ve always known our commitment to employees and financial stewardship, it is good to have others recognize our dedicated efforts. We've been named an Iowa Top Workplace by the Des Moines Register for four consecutive years, and included on Forbes’ “America’s Most Trustworthy Financial Companies” every year since 2014. Additionally, UFG is a super-regional property and casualty insurer rated “A” (Excellent) by A.M. Best Company.

 

The Senior Workers’ Compensation Claims Rep is responsible for reviewing and processing workers compensation claims within reserve authority;  determining by investigation if a claim is compensable, reviewing coverages, establishing and maintaining adequate reserves;  informing, notifying and educating agents, marketing representatives, other departments and state agencies of decisions and results.

Responsibilities:
  • Handle Workers’ Comp claims involving lost time, PPD or PT exposure, litigation and claims of catastrophic nature.
  • Review assignments to determine the nature of the claim and action required as well as coverages involved.
  • Drive to the scene of the loss to inspect the accident site. Secure recorded statements. Interview injured persons to determine extent and severity of potential loss. Take photographs of accident site and injuries. Interview and take statements from any witnesses.
  • Review and interpret to determine whether the claim is payable under the applicable workers compensation statute.
  • Use data gathered to develop and maintain a schedule of regular payments for compensation benefits.
  • Write reports for the claim file to document all activity relating to the loss. Inform underwriting if increased hazards or unusual circumstances concerning a risk/policy exposure. 
  • Maintain necessary records for reference and diaries.
  • Answer phone inquiries from agents, insureds or claimants.
  • Compile and review information concerning losses from various sources including medical records, physician’s reports and wage information. Contact physicians, therapists, attorneys or others to obtain reports, bills or other information.  Determine extent of injury or possible malingering of claimants.  Determine/evaluate damages.  Evaluate information gathered to determine the dollar amount of the loss.
  • Follow consistent reserve practices to achieve the company guideline of overall reserve redundancy.
  • Assist supervisor in field training for new adjusters.
  • Select & guide counsel, prepare files for defense as well as attend hearings, depositions and trials as necessary.
  • Promotes positive working relationships with agents in the territory by keeping the producing agent informed of progress on claims. Visit agencies for periodic claim reviews.
  • Participate in company sponsored educational programs to develop and maintain knowledge of products, procedures and industry trends.
  • Attend state sponsored workers compensation meetings.

Qualifications:

Education:

  • 4 years college degree
  • WCLA, AIC or SCLA designations or on track to be completed within 3 years

Experience:

  • 5+ years of total claims experience
  • 5+ years of medical/health claims experience 

Knowledge, skills & abilities:

  • Ability to read, comprehend and interpret applicable statute and apply to loss. Have analytical ability to determine reserves.  Understand technical aspects of equipment used.
  • Ability to accurately assess the medical and wage data to assure accurate and timely benefit payments.
  • Knowledge and understanding of medical terminology read and interpret hospital and nursing records and physician’s reports.
  • Ability to relate impairment ratings to statute for compensation awards.
  • Must possess effective human relations skills, analytical skills, organization skills as well as oral and written communication skills.
  • Ability to thoroughly read, analyze and project current and future medical, wage and PPD/PT awards.
  • Understand the function of the courts, hearing officers and relate impairment ratings to the case at hand.


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Equal Opportunity Employer

UFG is an equal opportunity employer. All qualified applicants will receive consideration and will not be discriminated against on the basis of race, gender, sexual orientation, gender identity, disability, protected veteran or any other protected status. If you need a reasonable accommodation for any part of the employment process, please email humanresource@unitedfiregroup.com to provide the nature of your request. Only inquires for an accommodation will be responded to. For more information on rights protecting job applicants, click here: Equal Employment Opportunity (EEO), Employee Polygraph Protection Act (EPPA), Family and Medical Leave Act (FMLA).

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