Settlement Specialist

Status: Exempt

Reports to: A.V.P. Claims

Responsibilities:

Evaluate assigned cases for settlement. The major focus of referred cases will be claims that have reached a permanent and stationary status.

- Accept referrals of cases that have reached a permanent and stationary status from Claims Examiner or Claims Manager.

- Analysis the medical evidence to determine whether or not the medical report withstands legal scrutiny and credibility.

- Determine if the medical report addresses all issues relevant to the case; apportionment, etc.

- Rate all permanent and stationary reports for the level of permanent disability.

- Evaluate the proposed settlement and establish a settlement range.

- Document the justification for each proposed settlement in the claim file notes.

- Discuss and obtain settlement authority from the Claims Examiner or the Claims Manager.

- Make offers of settlement to the claimant or the applicant?s attorney.

- Maintain an active settlement diary and file a Declaration of Readiness when appropriate.

- Discuss the use of a defense QME or AME with the Claims Examiner if the treating physician?s report is not ratable, reasonable or credible.

- Settlement results will be maintained on a spreadsheet that must include the type of settlement, date of settlement, amount, approval and closing date, and the reserve increase or decrease.

- When counsel must be engaged assignments will be specific as to the legal issues and objectives.

- Twelve cases per month must be settled.

Qualifications:

College degree preferred or equivalent work history. Minimum five to seven years of California Workers? Compensation claims handling experience required. Must have excellent knowledge of all aspects of California Workers? Compensation claims handling.

Must have current knowledge of case law and the California Labor Code. Must have excellent communication skills, both written and oral. Must have effective interpersonal skills and problem solving skills in order to deal effectively with case managers, attorneys and claimants. Must have the ability to work independently and report results in a concise format. Must have excellent organizational skills and the ability to analysis data and formulate a plan of action. Must have the ability to maintain a positive work atmosphere in an environment of rapidly changing priorities.

This position description outlines the general nature of the position and it is not designed to include all duties and responsibilities performed by people assigned to this position.

Equal Opportunity Employer