• To analyze mid- and higher-level workers compensation claims to determine benefits due • To ensure ongoing adjudication of claims within company standards and industry best practices • To identify subrogation of claims and negotiate settlements • Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency • Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract • Communicates claim action with claimant and client • Ensures claim files are properly documented and claims coding is correct • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review