Litigation Specialist - Workers Compensation

Posted 2 Days Ago
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Hiring Remotely in De Witt, NY, USA
In-Office or Remote
84K-100K Annually
Senior level
Insurance • Professional Services
The Role
Investigates, evaluates, negotiates, and resolves complex litigated workers’ compensation claims. The role manages reserves, litigation strategy, defense counsel, vendors, regulatory compliance, claim diaries, hearings, and financial outcomes. It requires strong knowledge of New York workers’ compensation laws, claims handling, litigation management, and negotiation, along with effective communication and organization. Regional travel may be required for hearings and trials.
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Job Summary & Responsibilities

Investigates, evaluates and resolves complex and litigated workers' compensation claims in order to achieve prompt and appropriate outcomes. Provides a superior level of customer service to internal and external business partners. Administers and resolves claims in a timely manner and in accordance with legal statutes, policy provisions, and company guidelines.

 

Responsibilities:

  • Promptly evaluates all assigned claims; establishes and executes a strategy to mitigate indemnity, medical and allocated loss adjustment expense exposure. Ensures timely disposition of all claims in accordance with regulatory and statutory requirements.
  • Tracks status of assigned clams, individually and in the aggregate, using available management reports and tools such as Excel, including but not limited to such information as permanency evaluations, hearing dates, attorney information, settlement evaluation, venue, judges, current litigation status, subrogation credits due, and overall financial outcomes.
  • Within granted authority, assures appropriate loss and expense reserves were established with documented rationale. Maintains and adjusts reserves over the life of the litigation to reflect changes in exposure, keeping in compliance with reserve authorization process. Notifies appropriate claim management when exposure exceeds authority. Negotiates claims resolution within granted authority.
  • Establishes and executes appropriate action plans for claim resolution including loss cost management while achieving appropriate financial balance between allocated expense and loss outcome.
  • Works collaboratively with multiple internal and external professionals and business partners in reaching appropriate disposition of all claims.
  • Selects and manages service vendors to achieve appropriate balance between allocated expense and loss outcome.
  • Maintains a very strong working knowledge of applicable regulatory and jurisdictional requirements.
  • Demonstrates technical proficiency through timely, consistent execution of best claim practices and established claims handling guidelines.
  • Communicates effectively with internal and external customers on claims and account issues. Provides a high degree  of customer service.
  • Maintains and manages a diary system and claim pending to efficiently and effectively resolve all claims.
  • Manages litigation to achieve appropriate financial outcomes. Effectively manages defense counsel to properly protect the insured and Lodestar interests.
  • Participates with claims management in the counsel evaluation process of staff and panel counsel. Makes recommendations for the addition / deletion of counsel.
  • Potential regional travel for attendance at hearings and trials.
  • 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

Preferred Qualifications
  • NY License required.
  • A minimum of 7 years of progressively responsible experience in handling NY complex workers compensation claims and workers compensation litigation required.
  • Bachelor's degree desired.
  • Strong level of expertise in commercial workers compensation coverage, evaluation and negotiation techniques.
  • Strong organizational skills and detail oriented.
  • Ability to work independently, prioritize workload, handle multiple tasks simultaneously and exercise good judgment.
  • Working knowledge of workers compensation claims handling practices.
  • Excellent verbal and written communication skills, including a strong ability to actively lead or participate in meetings, presentations and seminars
  • Excellent customer service skills, with emphasis on accessibility and responsiveness.
  • Computer literacy, including experience in Word, Excel and PowerPoint.
  • Strong litigation management skills and extensive knowledge of applicable regulations, legislation and judicial decisions in relevant jurisdictions.

 

Lodestar is providing applicants with the anticipated wage range for this position in compliance with state regulations. The wage range for this role is $84,000 to $100,000.  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.



Skills Required

  • New York workers’ compensation license
  • At least 7 years of progressively responsible experience handling complex New York workers’ compensation claims and litigation
  • Bachelor’s degree
  • Expertise in commercial workers’ compensation coverage, evaluation, and negotiation techniques
  • Strong organizational skills and attention to detail
  • Ability to work independently, prioritize workload, manage multiple tasks, and exercise sound judgment
  • Working knowledge of workers’ compensation claims handling practices
  • Excellent verbal and written communication skills
  • Ability to lead or participate in meetings, presentations, and seminars
  • Excellent customer service skills, accessibility, and responsiveness
  • Computer literacy and experience with Word, Excel, and PowerPoint
  • Strong litigation management skills and extensive knowledge of applicable regulations, legislation, and judicial decisions
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The Company
15 Employees
Year Founded: 2023

What We Do

Lodestar Claims & Risk Services, Inc. is a national Third Party Administrator (TPA) that provides comprehensive claims management, risk services, and client support. The company focuses on delivering responsive, results-driven claims services while fostering a culture of accountability, professional growth, and a people-first approach. They act as a trusted partner to their clients, simplifying complex claims processes and protecting people through expertise and critical thinking.

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