Technical Claims Representative - Workers Comp

“We make magic.” That’s our motto at Walt Disney Parks and Resorts. And it permeates everything we do. At Disney, you’ll help inspire that magic by enabling our teams to push the limits of entertainment and create the never-before seen!

What You Will Do:

The qualified candidate will be responsible for the investigation, management, and disposition of Florida workers' compensation claims for the Walt Disney World Resort and affiliated companies. Day-to-day responsibilities include but are not limited to completing investigations to determine compensability, evaluate workers compensation case exposure, manage and direct medical treatment. Candidate will work closely with our legal department in handling litigated cases and handle excess reportable cases. They will attend mediations, depositions and meetings involving litigated cases. Candidates should be comfortable presenting training and information sessions to an audience and to leaders across the Resort. The qualified candidate will participate in initiatives to meet department’s goals. Candidates must be willing to have periodic on-call responsibilities, which in some cases will necessitate responding to incidents after hours.

Required Qualifications & Skills:

• Florida 6-20 All-Lines Adjuster license in good standing
• Minimum of 5 years workers compensation claims handling experience
• Demonstrated ability to administer litigated claims, including experience in depositions, hearing testimony, mediation, and comprehensive case evaluation
• Demonstrated ability to effectively solve problems and make decisions
• Proven ability to deliver concise and informative written summaries in memo and presentation format, with appropriate business writing and usage of professional grammar
• Demonstrated ability to prepare and submit excess carrier claims reports and monitor/track reimbursement.
• Proven ability to communicate and work with all levels of Cast Members
• Ability to work under deadline pressures and effectively prioritize multiple tasks in a fast-paced environment
• Demonstrated strong relationship-building, negotiating, and influencing abilities
• Demonstrated ability to train and mentor claims representatives on all aspects of claims administration
• Demonstrated ability to handle confidential information
• Demonstrated strong organizational skills
• Demonstrated excellent time management skills
• Demonstrated familiarity with automated claims administration and management systems
• Demonstrated understanding of medical and legal terminology
• Ability to complete compliance related claims documentation to support federal and state reporting
• Computer proficiency within a Windows environment, including Outlook, Word, Excel, PowerPoint, and TEAMS
• Ability to work in multiple computer programs and in a paperless claim’s environment.

Preferred Qualifications:

• 10+ years claims handling experience adjusting Florida Workers' Compensation claims
• Proven Third Party Administrator or Employer Self-Administered workers' compensation claims handling
• Demonstrated ability to administer claims with complex Medicare Set Aside considerations and claims with costly and complex medical treatment
• Proven bilingual ability

Education:

• Bachelor’s degree or equivalent experience

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