Litigation Specialist - CA
Company: PMA Companies
Posted on: May 28, 2023
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.
- 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
- 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
- Establishes and executes appropriate action plans for claim
resolution including loss cost management while achieving
appropriate financial balance between allocated expense and loss
- 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
- Communicates effectively with internal and external customers
on claims and account issues. Provides a high degree of customer
- 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 PMA 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
- 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.
Keywords: PMA Companies, Roseville , Litigation Specialist - CA, Other , Roseville, California
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