[Hiring] Senior Claims Representative @Berkley

Role Description

As a Senior Claims Representative, you will be responsible for the investigation, evaluation, mitigation and resolution of an inventory of lost time and catastrophic workers’ compensation injury claims in multiple jurisdictions.

• Investigate workers’ compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due.
• Calculate and set timely financial reserves and proactively manage reserve adequacy throughout claim lifecycle.
• Record and code injured worker demographics, job information and accident information in company’s claims management system and files necessary forms with state regulatory agencies.
• Issue timely payments to injured workers, medical providers and service vendors.
• Coordinate and actively manage medical treatment of injured workers to ensure timely rehabilitation.
• Negotiate settlements of claims within designated authority with injured workers and attorneys.
• Serve as the team’s subject matter expert of the Workers’ Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions.
• Identify and manage subrogation, Second Injury Fund and joint coverage recovery opportunities.
• Regularly communicate claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful manner.
• Notify management and develop reports for large exposure claims and comply with reinsurance reporting requirements.
• Manage the claims litigation process to ensure timely and cost-effective claims resolution.
• Monitor the expenses and effectiveness of managed care and investigation vendors.
• Periodically travel to attend hearings, conferences and training sessions.
• Attend and participate in claim file reviews with management and defense attorneys.
• Coordinate and lead special projects or processes as assigned by management.
• Assist with oversight and supervisory duties when the team supervisor is unavailable or as assigned by supervisor.
• Support management with training and staff development.
• Support management with vendor management activities.
• Continuously strive to improve our product and business results through innovation.
• Obtain and maintain adjuster license(s) in assigned jurisdictions.
• Candidates with California Workers' Compensation experience may be eligible for a remote work arrangement based on qualifications and business needs.

Qualifications

• 3 - 5 years of experience handling workers’ compensation claims.
• Excellent written and verbal communication skills.
• Strong interpersonal and relationship building skills.
• Exceptional time management and organization skills.
• Strong analytical and critical thinking skills.
• Ability to work independently and strategically problem solve.
• Ability to diplomatically manage conflict.
• Ability to develop relationships within the organization and work effectively across departments.
• Strong discretion and integrity in dealing with highly confidential and sensitive information.
• Detail oriented.

Requirements

• Bachelors’ degree or equivalent insurance industry work experience.
• AIC, ARM, CCP, or CPCU insurance designation preferred.

Benefits

• Competitive compensation plan.
• Robust benefits package for full-time regular employees.
• Health, dental, vision, life, disability, wellness, paid time off.
• 401(k) and profit-sharing plans.
• Salary Range: 75k - 110k.