Job Description

The purpose of this job is to investigate and resolve incidents of workers’ compensation claims.

1. Investigate, evaluate and resolve Medical Only and/or Lost Time employee injury claims
2. Facilitate and coordinate injured team member’s medical care, calculate and pay benefits based on statutory guidelines
3. Manage, document, analyze, negotiate and settle claims
4. Manage and control claim related documentation including Personally Identifiable Information (PII) and Health Insurance Portability and Accountability Act (HIPAA) related information
5. Provide reserve recommendation to Pilot Corporate Management for cases processed by TPA and applicable in-house claims
6. Resolve conflicts with claims in collaboration with senior or more tenured adjuster
7. Collaborate with defense counsel on litigation closure strategy
8. Manage litigation to obtain favorable outcome and resolution
9. Focus on loss prevention and hazard correction during claim handling
10. Model behaviors that support the company’s common purpose; ensure guests and team members are supported at the highest level
11. Ensure all activities are in compliance with rules, regulations, policies and procedures

Qualifications

• High school diploma or equivalent certification required
• Associate’s degree in business or related field preferred
• Minimum three years’ experience in related work experience preferred
• Intermediate Microsoft Office skills
• Strong Excel skills
• Strong conflict resolution and problem-solving skills
• Ability to handle multiple tasks, meet deadlines, and work independently
• Professional demeanor when communicating in person, email, or phone