Claims Representative

Responsibilities

• Strategically manage claims and claim-related issues to achieve cost-effective resolutions
• Investigate accident and injury circumstances to determine compensability
• Proactively manage open claims including medical case management and litigation management
• Facilitate resources such as legal, medical, and return-to-work consultants
• Communicate with stakeholders including policyholders, injured workers, and medical providers
• Coordinate benefit authorization and payment on compensable claims
• Evaluate and negotiate claims for settlement
• Maintain accurate and adequate reserves on all open claims
• Analyze medical records to understand claim progress and treatment appropriateness

Requirements

• 2 or more years of experience working directly with customers
• Ability to manage difficult conversations
• Proficiency with technology and multiple systems
• Ability to complete training and claims assessments within six months

Benefits

• Diverse medical, dental, and vision offerings
• 20 paid days off in the first full year plus 9 paid holidays
• Wellness programs including company-paid fitness facilities
• Professional development opportunities
• Paid time off for volunteering
• Quarterly incentive up to 12 percent of annual base salary

About the Company

Pinnacol Assurance provides workers’ compensation protection to Colorado employers and employees, focusing on innovation, compassion, and community impact.