Senior Claims Representative
Glen Allen, VA - USA
Job Summary
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.
- 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 companys 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 teams 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
- 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
- Bachelors degree or equivalent insurance industry work experience
- AIC ARM CCP or CPCU insurance designation preferred
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.
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.
Required Experience:
Senior IC
Key Skills
- Corporate Paralegal
- Baan
- IT Sales and Marketing
- Civil Quality Control
- Activex
- Jboss
About Company
Berkley is a leader in commercial lines insurance, with over 60+ specialized businesses - each with deep expertise in an industry, product, or regional niche.