Complex Claims Team Lead Workers Compensation

Berkshire Hathaway Direct Insurance Company (BHDIC) is the home of commercial small business insurance products biBerk Business Insurance and THREE by Berkshire Hathaway. Our Claims Department is looking for an experienced claims leader with a strong background in complex Workers’ Compensation claims. The Workers’ Compensation Complex Claims Team Lead will oversee a team handling nationwide highexposure and catastophic claims and manage a reduced pending of complex Workers’ Compensation claims. This role provides technical guidance on highly complex and highseverity Workers’ Compensation claims and requires a comprehensive knowledge of Workers’ compensation regulations, laws, and best practices. This role will report to the WC Coverage & Litigation Supervisor.

Location: This is a fulltime remote position. This position may require occasional travel to attend mediations, trainings, andor other related department meetings.

Job Responsibilities

The Claims Team Lead WC Complex Claims will be responsible for, but not limited to:

• Investigate coverage, determine compensability, and manage a reduced pending of high exposure Workers’ Compensation claims involving catastophic injuries and complex cases
• Proactively establish and update reserves to reflect claim exposure and document rationale
• Resolve claims within authority and make independent case value recommendations to senior leadership on cases which exceed authority
• Participate in reserving, pricing and strategy discussions with senior leadership
• Collaborate with defense counsel to effectively manage litigated files according to established litigation management guidelines
• Ensure compliance with state and federal Workers’ Compensation regulations
• Provide exceptional customer service to policyholders, agents, injured workers, medical providers, legal, and vendors
• Recruit, onboard, performance management, and development of team members
• Partner with Claims Supervisor to regularly identify and address training opportunities
• Assist team with escalated issues, claim strategies, coverage positions, and guide team members to the appropriate resources
• Conduct performance and development discussions with team members
• Follow escalation and reporting requirements on claims with significant exposure
• Develop creative resolution strategies to manage losses involving complex issues, effectively utilizing appropriate internal and external resources
• Conduct team roundtables to align on reserves and settlement values
• Prioritize weekly team meetings and regular checkin discussions with team members
• Document claim files in accordance with company and regulatory guidelines
• Identify subrogation potential and red flags requiring SIU involvement
• Train new team members; provide ongoing coaching and support to team
• Act as a technical resource and maintain continuing education requirements
• Participate as a Subject Matter Expert in complex projects related to the Workers’ Compensation line of business
• Coordinate and participate in training for less experienced claims staff

• Qualifications

  Knowledge & Experience:

  • Active adjuster license (TX, OK, or FL preferred)
  • 10+ years of experience handling complex workers’ compensation claims
  • Previous supervisory experience required
  • Excellent organizational, leadership, and time management skills
  • Experience with structured settlements and Medicare SetAsides
  • Ability to work in a fastpaced, collaborative, virtual office environment
  • Excellent written and verbal communication skills
  • Ability to work independently and meet assigned deadlines
  • Strong negotiation skills
  • Proficiency with MS Word, Excel and internet applications
  • Highly attentive to details
  • Able to work under pressure and execute good judgment in sensitive situations

  • Education:

    • BABS degree required
    • AIC, SCLA, CPCU or other industry designation a plus

    • About Us

      biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBerk.com will be underwritten by Berkshire Hathaway Direct Insurance Company (BHDIC), which is an AM Best rated A++ insurer.

      BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBerk are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.

      Some highlights of our benefits are:

      • Great work environment with growth opportunity
      • Subsidized downtown parking (for inoffice positions)
      • Competitive compensation
      • Generous amounts of vacation and sick time
      • Closed on major holidays
      • 401(k) with company match
      • A fantastic healthcare package
      • Tuition reimbursement after 6 months of employment
      • Service recognition after 5 years of employment

      • In accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided. The salary range for this position is $115,000 $135,000 per year. Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law.