In‐depth knowledge of workers’ compensation laws, statutes, and regulations across multiple jurisdictions, with the ability to interpret complex legal and medical documentation. Expert understanding of claims investigation techniques, compensability analysis, coverage verification, and advanced risk assessment. Extensive knowledge of medical terminology, treatment guidelines, return‐to‐work principles, and rehabilitation processes to evaluate claim progression and exposure. Strong understanding of litigation processes, including legal strategy, attorney management, settlement negotiation, legal bill review, and mediation practices. Advanced knowledge of reserve setting and financial exposure analysis, including actuarial impacts, trend evaluation, and loss forecasting. Exceptional analytical and critical‐thinking skills, capable of interpreting complex claim data, identifying red flags, and developing sophisticated mitigation strategies. High‐level communication and interpersonal skills, including the ability to explain complex workers’ compensation concepts clearly to clients, executives, and injured employees. Strong negotiation skills, including settlement evaluation, dispute resolution, and strategic communication with attorneys and adjusters. Advanced case‐management and organizational skills, with the ability to manage a high‐volume or high‐complexity caseload while ensuring accuracy, compliance, and timely action. Proficiency in claims software, medical management systems, and data tools, including advanced Excel skills for reporting, trend analysis, and reserve reviews. Expert documentation and reporting skills, including the ability to prepare high‐quality claim summaries, risk analyses, and client advisories. Strong client‐relationship and consultative skills, supporting program development, training, and strategic risk reduction. Capable of working effectively under supervision while also demonstrating initiative and accountability in completing tasks independently. Maintains a strong work ethic, reliability, and commitment to excellence in all responsibilities, with a focus on integrity, confidentiality, and continuous improvement. Ability to build strong partnerships with clients, TPAs, medical providers, outside counsel, and internal teams to ensure coordinated and effective claims handling. Ability to provide compassionate, expert‐level guidance to injured workers, balancing advocacy with employer interests and legal compliance. Ability to maintain strict confidentiality and comply with HIPAA, legal requirements, and organizational policies at all times. Proficiency with Microsoft Office software (Outlook, Microsoft Teams, Excel, Word, PowerPoint) and demonstrated ability to learn other applications as needed. Education & Experience Bachelor’s degree preferred in Risk Management, Business Administration, Human Resources or equivalent combination of experience, skills, education (including other relevant non-traditional degree programs, certifications, or job training programs) preferred. 4-5 years of progressively responsible multi-state workers’ compensation claims experience, ideally in a third-party administrator (TPA), insurance carrier, or employer-based risk management environment. Demonstrated expertise managing complex, high-exposure, and litigated claims, including catastrophic injuries, long-term medical management, and settlement negotiations. Proven experience conducting in-depth investigations, evaluating compensability, analyzing medical documentation, and determining financial exposure. Experience collaborating with TPA adjusters, defense attorneys, medical providers, vocational professionals, and employer leadership. Strong background in return-to-work coordination, including developing light-duty programs and advising clients on transitional work strategies. Experience providing client consultation, program improvement recommendations, and training on workers’ compensation practices and regulatory compliance. Advanced professional designations such as Workers’ Compensation Claims Associate/Professional (WCCA / WCCP), Associate in Claims (AIC), Associate in Risk Management (ARM), Certified Workers’ Compensation Professional (CWCP) or Chartered Property & Casualty Underwriter (CPCU) are desired. Required Licenses And/Or Certifications Not Applicable Physical, Mental, & Communication Demands Physical Demands: