PURPOSE OF THE JOB

The purpose of this job is to serve as a litigation representative to attend hearings, depositions, and resolve disputes as it applies to aspects of workers’ compensation claims. This position exists to reduce allocated loss adjustment expenses and improve results by proactively analyzing and resolving workers’ compensation claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Manages litigation and claim disputes as they apply to workers’ compensation claims.

• Attends claim hearings representing ICW Group.

• Appears at WCAB lien conferences and trials; may need to appear at status, priority, and mandatory settlement conferences on occasion.

• Schedules and attends settlement walk-through hearings with claimants and/or counsel.

• Reduces loss adjustment expenses by quickly and effectively resolving disputed claims and litigation, including liens.

• Resolves claims fairly and equitably, acting in the best interest of the insured. 

Prepares documentation necessary for assigned cases.

• Prepares court pleadings, reports, and settlement documents in accordance with statutory and case law as well as pertinent regulations.

• Prepares for and attends depositions; maintains notes and correspondence.

• Prepares and submits timely Hearing Reports to claims personnel and claims management.

• Reviews and analyzes the billed invoices and liens and compares with professional bill review analysis. 

Provides subject matter expertise in the litigation aspect of workers’ compensation claims.

• Applies appropriate legal defenses and negotiates resolution or set for trial.

• Provides guidance and expertise to other department’s operations, including Underwriting and Risk Management Services.

• Partners with Claims Examiner to determine solutions. 

SUPERVISORY RESPONSIBILITIES

This role does not have supervisory responsibilities.

EDUCATION AND EXPERIENCE

Bachelor's degree from four-year college or university in Business Administration, Management or related field, or equivalent combination of education and experience.  Minimum 2-5 years of experience in workers' compensation required, with claims examiner experience preferred.

CERTIFICATES, LICENSES, REGISTRATIONS

None required.

KNOWLEDGE AND SKILLS

Working knowledge of claims and insurance industry preferred.  Familiarity with and ability to effectively utilize the CA Labor Code, CA Code of Regulations, and CA Schedule for Rating Permanent Disabilities to rate disability impairment. Ability to read, analyze, and interpret technical journals, financial reports, and/or legal documents. Ability to respond to common inquiries or complaints from counsel, claimants, customers, regulatory agencies, and/or members of the business community. Ability to effectively present information to top management, public groups, and/or boards of directors. Strong ability to negotiate to resolution various legal issues before the WCAB with opposing counsel, proper claimants, and co-defendants. Strong oral skills to articulate company’s position in contested legal matters to opposing side, Information Officers, and WCAB judges.

PHYSICAL REQUIREMENTS 

This position requires some travel – up to 20 hours per week. Works with computers and computer screens for multiple hours per day; must be able to lift and carry 25-40 pounds. Position is sedentary approximately 80% of time. Must be able to drive and be comfortable working independently.

WORK ENVIRONMENT 

This position is a hybrid field/office position. Field environment includes appearing at various WCAB district offices, driving to and from appointments/appearances, meeting with attorneys/judges, and use of cell phone/email. Office environment includes use of a computer, telephone, copier and other standard office equipment.

We are currently not offering employment sponsorship for this opportunity

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