Job Description

Worker\'s Compensation Claims Representative SFM \xe2\x80\x93 The Work Comp Experts Work somewhere you love Since 1983, our mission has been to be the workers\xe2\x80\x99 compensation partner of choice for agents, employers and their workers. In that time, we\xe2\x80\x99ve expanded to over 30,000 customers in the Midwest and grown our offerings to include vocational rehabilitation, loss prevention, medical services and more. SFM is unique in that we are small enough that your voice is heard but has all the benefits and perks of a larger employer. We value your opinion, help you reach your goals, and make it easy for you to maintain work-life balance. SFM is committed to creating the best work environment and believes that our exceptional and motivated employees are our greatest strength. SFM emphasizes work life balance, and our benefit package is designed to assist you navigate your work-life journey. Our benefits include:

• Affordable Medical, Dental, Vision Insurance, HSA, FSA
• Traditional and Roth 401(k) plans with company match
• Company contributions to help pay off student loans
• Monthly home internet allowance
• Free life insurance, STD & LTD
• Hybrid work
• Opportunities for annual gainshare bonus
• Pet insurance
• Generous PTO
• 9 paid holidays
• Paid parental leave
• Annual company-wide volunteer day
• Adoption financial assistance

Visit our careers page to learn more about working at SFM. The role The primary focus will be handling workers\' compensation claims for the state of Iowa. As a Work Comp Claims Rep you will Investigate and manage claims in accordance with state workers\xe2\x80\x99 compensation statutes, case law, and Company best practices. You will calculate lost wages and manage more complex medical claims. This is a customer focused position and claims are handled so that a successful resolution is achieved for all parties. Working collaboratively in a multifunctional team is key to being successful in this role. The multi-functional team environment is what makes SFM different from other companies. Experienced adjusters are encouraged to apply and will be considered for a higher level. This is a work from home position and you must live in Iowa. This a fully remote position. Responsibilities

• Makes timely contact with all parties to a claim to gather necessary information to determine liability and fulfill regulatory, contractual, and internal reporting requirements. Applies the workers\xe2\x80\x99 compensation statute and case law to facts to determine compensability. Uses internal resources as required by company best practices or client servicing instructions for questionable compensability decisions and subrogation or fraud issues.

• Sets expectations with the injured worker and employer of wellness, stay-at-work, or return-to-work, and importance of ongoing communication between all parties. Involve strategic business partners, to assist with return-to-work or stay-at-work.

• Authorizes payment of medical and wage loss benefits within payment authority.

• Assigns, directs, and manages medical, rehabilitation and legal services pursuant to the respective business\xe2\x80\x99s procedures, client service instruction and applicant state law. This includes documentation in claim comments of facts, issues and plans.

• If needed, attends field visits of policyholders, agents and injured workers, with assistance as needed. May include travel.

• Establishes initial and ongoing case reserves within authority level that accurately reflect file exposure in accordance with Company best practices and client reserving guidelines relating to qualitative analysis and timing. Recommends reserves for cases that exceed authority level.

• Communicates and educates the employer on case exposure/reserves and how to mitigate the exposure. Communicates and partners with the reinsurer regarding case exposure/reserves, high expense items and issues which impact future costs.

• Provides and documents strategy to bring cases to resolution per SFM best practices, procedures and philosophy. This is evidenced by documenting files in claim comments with 1) timely action plans; 2) pertinent facts and issues for roundtable discussions; and 3) analysis of settlement exposure, including, with assistance, the use of spreadsheets.