*We are seeking applicants with a local presence in Knoxville, TN or the surrounding communities*
The purpose of this Knoxville, TN based job is to investigate and resolve incidents of workers’ compensation claims.
- Investigate, evaluate and resolve Medical Only and/or Lost Time employee injury claims
- Facilitate and coordinate injured team member’s medical care, calculate and pay benefits based on statutory guidelines
- Manage, document, analyze, negotiate and settle claims
- Manage and control claim related documentation including Personally Identifiable Information (PII) and Health Insurance Portability and Accountability Act (HIPAA) related information
- Provide reserve recommendation to Pilot Corporate Management for cases processed by TPA and applicable in-house claims
- Resolve conflicts with claims in collaboration with senior or more tenured adjuster
- Collaborate with defense counsel on litigation closure strategy
- Manage litigation to obtain favorable outcome and resolution
- Focus on loss prevention and hazard correction during claim handling
- Model behaviors that support the company’s common purpose; ensure guests and team members are supported at the highest level
- Ensure all activities are in compliance with rules, regulations, policies and procedures