Workers' Compensation Claim Administrator

The Hartford•Lake Mary, FL

8h•Hybrid

About The Position

The Workers’ Compensation Claim Administrator role will work within established procedures in adherence to statutory, regulatory, and ethical requirements. Our dynamic team of claim professionals provide superb customer service with the valuation, and disposition of claims while adhering to our corporate claim’s excellence polices.

Requirements

HS Diploma required
2+ years of customer service experience preferred
Ability to meet productivity targets in a fast-paced, team-oriented environment
Excellent written and communication skills with the ability to resolve service issues
Possess strong time management and organizational skills
Ability to adapt and flourish using industry-changing workflows
Ability to self-manage competing priorities while delivering accurate work within key timelines
Strong computer proficiency in the MS Office Suite (Word, Excel, Outlook & PowerPoint)
As a condition of your employment, you must obtain and maintain a State Adjuster's License to process Property & Casualty Insurance. Continued employment with The Hartford is contingent upon the successful passage of the Licensing exam within 1 year from your date of hire.

Nice To Haves

Prior workers’ compensation insurance claim handling is preferred
Bachelor’s Degree is preferred

Responsibilities

Effectively manage workers’ compensation claims requiring coverage and compensability investigations as identified from First Notice of Loss in multiple jurisdictions.
Identify co-morbid conditions/prior conditions that may affect the original or ongoing compensability decision of the claim.
Provide benefit oversight and file disposition appropriate for claim complexity and adherence to statutory guidelines for all claims.
Leverage a network of internal partner resources such as: nurses, utilization review, and subject matter experts to help with disposition of the claim.
Identify and investigate potential fraud red flags, inclusive of referral to SIU.
Provide exceptional customer service by establishing and maintaining productive business relationships with internal and external customers through written and verbal communication.
Utilize critical thinking skills to gather and analyze data information to inform critical claim decisions, such as coverage analysis, compensability decisions, escalation of injury complexity, attorney representation, and potential red flags.
Leverage contemporary technology to achieve accurate and efficient claim outcomes.