ESSENTIAL FUNCTIONS & RESPONSIBILITIES • Analyze and process complex CA workers' compensation claims by investigating and gathering information to determine the exposure on the claim. • Examine and process claims through well-developed action plans to an appropriate and timely resolution. • Negotiate settlement of claims. • Calculate and assign timely and appropriate reserves to claims. • Calculate and pay benefits due; approve and make timely claim payments and adjustments. • Prepare necessary state filings within statutory limits. • Oversee the litigation process and ensure timely and cost-effective claims resolution. • Coordinate vendor referrals for additional investigation and/or litigation management. • Process claims recoveries, including but not limited to subrogation and excess recoveries. • Report claims to the excess carriers and respond to requests in a professional and timely manner. • Communicate claim activity and processing with the claimant. • Ensure claim files are properly documented, and claim coding is correct.