Senior Claims Representative

Responsibilities

• What you can expect:
• Determine compensability as required by Company best practices, case law and the Colorado Workers' Compensation Act.
• 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 well as filing all appropriate paperwork with the Colorado DOWC as required by Company best practices, case law and the Colorado Workers' Compensation Act.
• Provide authority for level 1 and 2 CRs to settle claims within senior CR authority. This includes examination of their settlement evaluation, coaching on opportunities where appropriate, and documentation of the authority.
• Inform policyholders and agents of claim status and significant development as required by Company best practices.
• Set and maintain current, accurate and adequate reserves by reviewing medical records and determining the likely future treatment for the specific injury and circumstances. Must utilize knowledge of likely treatment and outcomes for a variety of injuries,

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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