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We are open to fill this position as a Claims Specialist II or Senior Claims Specialist based on experience. Office is located in Kent, WA, with fully supported home / remote work opportunities.
• Acts as senior technical professional on team, assisting team members with escalated issues.
• May mentor and train new team members.
• May participate in Quality Review process. Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim.
• Plans and conducts investigations of claims (including such activities as interviewing insureds, witnesses and claimants, collecting and evaluating appropriate documentation and securing evidence and protecting the chain of custody) to analyze and confirm coverage and to determine liability, compensability and damages; determines need for, and engages independent adjusters, cause and origin experts and independent medical examiners.
• Determines and documents, during the investigation process, the potential for subrogation, and pursues recovery.
• Coordinates the litigation activities associated with assigned claims to ensure timely and cost-effective resolution; may participate in mediation and hearings.
• Performs other duties, as assigned.
The highly qualified candidate will possess the following skills and experience:
• Bachelor’s Degree (or equivalent training) plus 3-5 years’ directly related work experience.
• Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required.
• Leadership ability and demonstrated time management skills to delegate work appropriately and organize resources effectively.
• Demonstrates an advanced knowledge of claims case handling practices, legal liability, general insurance policy coverage, and the state`s Workers Compensation laws.
• Required to obtain and maintain all applicable licenses or industry certifications.
We value your hard work, integrity and commitment to positive change. In return for your service, it’s our privilege to offer you benefits and rewards that support your life and well-being. To learn more about our benefit offerings please visit: https://LMI.co/Benefits
Within the department, the Workers’ Compensation unit is a service-driven and focused team that seeks to provide effective customer service improvements and proactive claims management. This unit has an operating budget of almost $2M and consists of nine workers’ compensation professional staff who are responsible for the administration of the City’s workers’ compensation program, administering over $20M in claims each year. We have recently launched a new claim system to bring the unit modern technology and take us into a paperless environment. To support the continued success of this unit, we are looking for a Senior Workers’ Compensation Analyst to analyze and effectively manage the most complex and technically challenging workers’ compensation claims. This position will provide you with the opportunity to act as a knowledgeable consultant to your teammates, utilizing your critical thinking and sound judgment to resolve intricate claims issues.