Claims Representative

Responsibilities

• What you can expect:
• Determine compensability as required by Company best practices, case law and the Colorado Workers' Compensation Act.
• Proactively communicate and correspond with stakeholders as needed to manage and resolve open claims, including but not limited to policyholders, injured workers, agents, medical providers, service vendors and resources, attorneys and regulatory agency representatives.
• Facilitate early return to work for injured workers by working with policyholder, and Return-to-Work Consultant if needed.
• Facilitate and coordinate benefit authorization and payment on compensable claims as required by Company best practices, case law and the Colorado Workers' Compensation Act.
• Evaluate and negotiate claims for settlement as required by Company best practices.
• Educate and inform policyholders and agents on workers compensation and the status of individual claims status and significant development as required by Company best practices.
• Set and maintain current, accurate and adequate reserves on all open claims according to company best practices.
• Prepare for, attend and testify at settlement conferences and hearings as determined appropriate by leadership.
• ADDITIONAL DUTIES
• Serve as resource to other claims representatives as requested by the business team as well as the claims discipline as needed.
• Serve on projects and committees as requested.
• Continue education toward management of increasingly more complicated claims to prepare for Claims

Additional Information

Pinnacol Assurance does just one thing, and does it better than anyone: provide caring workers' compensation protection to Colorado employers and employees. And while we may be a little biased, we believe that our work shapes communities and changes lives. We have big hearts and love big ideas. We've been around for more than 100 years, but don't let that fool you. Pinnacol is committed to taking care of Colorado employers and workers in the most innovative ways. We celebrate continuous improvement, new ideas, compassion, teamwork, integrity and excellence.

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