JOB REQUIREMENTS: Claims Specialist Cities and Villages Mutual Insurance Company Wauwatosa, WI Summary of Job Under the general supervision of the Worker\'s Compensation Claims Manager, this position is responsible for investigating, processing and adjusting worker\'s compensation claims. Some travel may be required with occasional overnight stays. WHY JOIN THE CVMIC TEAM: The ability to make a difference to our municipal clients/members! Great variety in what you do each day Flexibility with your schedule, including the ability to work remotely A supportive team environment Outstanding benefits that include: Company-paid retirement contribution into a Simplified Employee Pension (SEP) Plan: 12.1% of salary, after one year of employment, Company-paid health insurance premiums, and tuition reimbursement for continued opportunities for growth and development! View what employees say about working at CVMIC! Learn more about CVMIC! Essential Duties & Responsibilities Reviews first report of injury forms (WC-12) and follow up with claimants, insureds, medical providers or others in a timely manner to determine compensability. Files required State forms in a timely and accurate manner. Processes new claims, sets and monitors reserves. Maintains up to date files and diaries on all active claims. Interviews, telephones, or corresponds with municipal client/member representatives, employees, and supervisors, claimants, witnesses and medical personnel; reviews medical and hospital records in a timely manner to determine compensability while maintaining required confidentiality. Recommends and sets up Independent Medical Evaluations, Vocational Evaluations and assigns Rehabilitation Nurses as necessary. Reviews and pays medical bills and indemnity benefits. Submits medical bills for third party review. Identifies and reports claims with re-insurance/excess insurance exposure to the carrier, Claims Manager and CEO. Exercises discretion within settlement authority to pay, deny or settle claims and establish reserves on claims. Exercises discretion with respect to investigating claims and processing medical bills and indemnity payments. Discretion is also required with respect to all Company procedures to allow for the flexibility needed to process claims properly and in a timely manner. Recommends litigation when settlement cannot be negotiated; Oversees litigation on contested cases. Assigns work, provides oversight and reviews files of Claims Assistants and Med-Only Claims Specialist. Monitors claims to identify and follow-up on subrogation opportunities. Other Duties & Responsibilities Attends Administrative hearings. Conducts claim file review with municipal clients/members. Provides Worker\'s Compensation training for municipal clients/members as needed. Qualifications To perform this job successfully, an individual must... For full info follow application link. MRA is an Equal Opportunity/Affirmative Action Employer ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/F0F81EFE19DE4B91