Company Details:
BerkleyNet is an innovative workers compensation insurance provider that does all of our business online. Our Goal? To make doing business “Ridiculously Fast. Amazingly Easy.”
Responsibilities:
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
- Assists 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 strives 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
Education Requirement
- Bachelors’ degree or equivalent insurance industry work experience
- AIC, ARM, CCP, or CPCU insurance designation preferred
Additional Company Details:
The Company is an equal employment opportunity employer.
We do not accept any unsolicited resumes from external recruiting firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees.
Base salary & Benefits include Health, dental, vision, life, disability, wellness, paid time off, 401(k) and profit-sharing plans.
Salary Range: 75k - 110k
The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
