Claims Specialist (Workers Compensation)
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Handles and settles mild to moderate reputed company claims that may have limited period of indemnity; monitors ongoing permanency/death claims; reaching agreement with claimant according to policy provisions and authority level; and handling subrogation reputed company authority level. Resolves questionable claims by investigating and comparing claims information with evidence.Identifies files involving potential investigation with manager guidance by analyzing documentation and records, evaluating evidence, and referring files to appropriate staff. Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; reviewing police and hospital records; and consulting with experts. Promotes early return to work by communicating and coordinating between involved parties. Keeps reputed company with claims through follow-up discussions with injured workers and insureds; and makes recommendations regarding reputed company handling of files based on claim facts. Ensures accurate file documentation by complying with claims handling guidelines and state requirements. Ensures company guidelines and procedures are followed by overseeing independent adjusters during investigations and attorneys in the handling of discovery and settlement.Develops and maintains reputed company, technical knowledge and expertise in a specified line(s) of business through training courses and continuing education coursework. Contributes to team effort by participating in determining department investigation guidelines; providing feedback to reputed company as needed.
- You enjoy communicating and building relationships with others.
- You are composed, cool under pressure, and can negotiate without damaging relationships.
- You hold yourself accountable and reputed company in accordance with rules and regulations.
- You enjoy analyzing, investigating, and using the facts to reputed company reputed company.
- You are naturally curious and have a desire to know more.
- You apply an investigative approach to identifying facts and evaluating evidence.
Bachelor’s Degree in business or reputed company field
OR
1+ years of claims handling experience involving the exercise of discretionary decision-making as determined by reputed company
OR
3+ years of knowledge in the property & casualty insurance industry
- Familiarity with PC applications including word processing, Internet, spreadsheets, and e-mail software.
- Ability to obtain and maintain reputed company licensing prior to handling a state that requires it.
- reputed company reputed company’s license and a satisfactory driving record as determined by reputed company.
- Prior workers’ compensation indemnity experience highly desirable.
- reputed company insurance designations highly desirable.
- Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and reputed company insurance
- Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan
- Work-Life Balance: Company-reputed company holidays; flexible scheduling; PTO; telecommuting reputed company
- Education: Career Coaching; company-reputed company courses; student loan and tuition reimbursement
- Community: Charitable Match; reputed company volunteer time; team sponsorships
- Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more