• Evaluates and establishes an action plan to manage medical and indemnity benefits associated with injury and occupational disease claims to their most cost-effective conclusion. • Decides the outcome of the claim using sound judgment by applying established policy, procedures, regulations and guidelines. • Gathers facts by conducting interviews with all involved parties and considers all the elements of the claim prior to issuing a decision. • Takes recorded statements when necessary. • Determines eligibility of indemnity and medical benefits once salary information and medical treatment plans have been secured and processed within the designated authority levels. • Utilizes proactive reserving behaviors to ensure adequate case reserves which reflect the probable ultimate outcome based on the current known circumstances throughout the life of the claim. • Actively identifies and develops the investigation of and pursuit of subrogation recoveries when possible. • Consults with assigned claim director, return to work specialists, nurse case managers, internal/external medical, and legal on current and/or recommended treatment, litigation or rehabilitation plans to ensure claims outcomes are achievable and appropriate. • Works collaboratively with the injured worker, employer, outside counsel, and health and rehabilitation professionals to manage the claims costs and promote quality medical care. • Works collaboratively with the injured worker, employer, assigned return to work specialist, and medical providers to facilitate the injured worker’s safe and timely return to work. • Manages claims litigation, including expenses, by collaborating and providing direction to panel counsel throughout the life of the claim. • Analyzes reports from external resources such as physicians, attorneys, and/or vocational rehabilitation experts to evaluate and adjust claim strategies as needed. • Evaluates and negotiates claim settlements utilizing human relation skills and technical knowledge to achieve the best possible outcome. • Presents and summarizes claim details at internal team staffing, participates in discussions, and provides guidance as needed. • Consults with assigned claim director if the loss becomes significantly complex or presents significantly increasing financial exposure. • Follows established claims best practices related to medical management, litigation, fraud/abuse and recovery. • Effectively and independently uses available resources to prioritize, organize, and complete work in a timely manner to meet jurisdictional requirements, timeframes, and internal metrics. • Develops presentations for special projects such as internal/external meetings and conferences as needed. • Participates in claim reviews, onboardings, etc. for our policyholders and agents. • Proactively collaborates with our policyholders to ensure alignment of objectives and foster continuous improvement.

• Provide timely and accurate service to customers (primarily active employees) • Assist in processing HR documents, i.e. benefit, salary, and status changes • Provide information on a wide range of human resources programs and services (via phone, chat, AskHR cases) • Expedite referral of complex issues and sensitive inquiries to the appropriate area for resolution including, but not limited to, benefits, leaves of absence, payroll, HR policy, training, and work-life programs

• Align business objectives with employees and management in designated business units. • Formulate partnerships across HR function to deliver value-added service to management and employees. • Maintain effective business literacy regarding financial position, midrange plans, culture, and competition. • Coach and mentor positions in the department.

• Serving as a trusted resource for Core Leaders and Caregivers who face employee relations matters • Ensuring consistent approaches to positive employee and labor relations • Compliance with HR policies, regulatory and policy requirements and standards • Conducting investigations and recommendations for workplace environment improvement • Employee relations research, identifying trends and patterns and need for critical intervention • Labor relations research, dispute alternatives and policy development • Effective recordkeeping and data integrity • Maintaining HR metrics and dashboards and reports to other HR professionals