Senior Claims Specialist - Workers Compensation

As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines. **Responsibilities:** * Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature * Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable) * Alert Supervisor and Special Investigations Unit to potentially suspect claims * Ensure timely denial or payment of benefits in accordance with jurisdictional requirements * Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure * Negotiate claims settlements with client approval * Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition * Work collaboratively with Lodestar nurse professionals to develop and execute return to work strategies * Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome * Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced * Demonstrate technical proficiency through timely, consistent execution of best claim practices * Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues * Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account\-specific sessions * Authorize treatment based on the practiced protocols established by statute or the Lodestar Managed Care department * Assist Lodestar clients by suggesting panel provider information in accordance with applicable state statutes. * Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work. **\#LI\-Remote** Requirements: * Bachelor's degree, or four or more years of equivalent work experience required in an insurance related industry required * At least 3\-5 years' experience handling lost time workers compensation claims required; past experience with NY jurisdiction is required * Associate in Claims (AIC) Designation or similar professional designation desired. * Active license required or ability to obtain license within 90 days of employment in mandated states. * Familiarity with medical terminology and/or Workers' Compensation * Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously * Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details * Strong verbal, written communication skills and customer service skills * Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint. * Ability to travel for business purposes, approximately less than 10%. Lodestar is providing applicants with the anticipated wage range for this position in compliance with state regulations. The wage range for this role is $69,000 to $88,000\. Wage ranges are based on national market data and may cover a wide range of geographies. Applicants may be paid above, within or below this range based on a variety of factors