Posted: Thursday, December 14, 2023 03:55 PM


*Summary: *Investigates, evaluates and determines compensability of claims, by performing the following duties. *Essential Duties and Responsibilities *include the following. Other duties may be assigned. Assigned duties of Claim Representative II. Performs investigative duties as required on a case by case basis. Reviews case law and resolves compensable medical only and non-litigated claims within the applicable laws and statutes. Estimates reserving for projected cost of claims through resolution, including indemnity benefits, permanency, medical treatments, etc. Makes referral to nurse case managers if additional medical support is required, and for surveillance when necessary. Directs claim assistants on duties to be performed for handling of claims. Negotiates settlement within designated authority. *Competency:* To perform the job successfully, an individual should demonstrate the following competencies: *Problem Solving* - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics. *Customer Service* - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments. *Interpersonal -* Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. *Oral Communication* - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. *Organizational Support* - Follows policies and procedures; Completes administrative tasks correctly and on time; Supports organization's goals and values; Benefits organization through outside activities; Supports affirmative action and respects diversity. *Planning/Organizing* - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans. *Quality *- Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality. *Adaptability* Adapts to changes in the work environment; manages competing demands; changes approach or method to best fit the situation; able to deal with frequent change, delays, or unexpected events. *Teamwork* Balances team and individual responsibilities; exhibits objectivity and openness to others’ views; gives and welcomes feedback; contributes to building a positive team spirit; puts success of team above own interests; able to build morale and group commitments to goals and objectives; supports everyone’s efforts to succeed; recognizes accomplishments of other team members. *Analytical* Synthesizes complex or diverse information; collects and researches data; uses intuition and experience to complement data; designs work flows and procedures. *Written Communication* Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; able to read and interpret written information. *Motivation* Sets and achieves challenging goals; demonstrates persistence and overcomes obstacles; measures self against standard of excellence; takes calculated risks to accomplish goals. *Qualifications:* To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. *Education/Experience:* BS Degree or equivalent experience and one to three years of directly related experience. *Language Ability:* Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. *Reasoning Ability:* Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. *Computer Skills:* To perform this job successfully, an individual should have knowledge of Word Processing software and Spreadsheet software. *Certificates and Licenses:* (8) Hours of Continued Education on an annual basis. *Physical Demands:* The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Specific vision abilities required by this job include that the employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision. While performing the duties of this job, the employee is occasionally required to stand; walk and sit. Job Type: Full-time Benefits: * 401(k) * 401(k) matching * Dental insurance * Flexible spending account * Health insurance * Life insurance * Paid time off * Retirement plan * Vision insurance Schedule: * 8 hour shift * Monday to Friday Education: * Bachelor's (Preferred) Experience: * Worker's Compensation Claims: 1 year (Required) Work Location: In person

Price - 45400 - 57400

• Location: Birmingham, AL Birmingham, AL Alabama

• Post ID: 3409201500 Birmingham

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