Claims Representative Workers' Compensation

Who are we

Western National Insurance Group is a private mutual insurance company with over 120 years of experience serving customers property-and-casualty insurance needs in the Midwestern Northwestern and Southwestern United States. Known as The Relationship Company we define success as a measure of the relationships weve built over everything that we do we know that delivering a friendly and helpful interaction makes for a better experience for everyone involved. Thats the power of nice. At Western National nice is something we work to bring to every person and organization with whom we partner and serve.

Does this opportunity interest you

Western National is seeking a Workers Compensation Claims Representative to join our team!

The individual in this role will have the opportunity to investigate evaluate negotiate and resolve Workers Compensation insurance claims as assigned.

What are the responsibilities and opportunities of this role

• Investigates evaluates negotiates and resolves Workers Compensation claims as assigned.
• Handles moderate-to-high complexity claims within settlement authority.
• Ensures customer service excellence.
• Investigates and reviews policy forms facts and documents related to claims to make appropriate decisions on claims resolution.
• Assesses claim exposures and develops strategic action plans to drive efficient fair and cost-effective resolutions.
• Establishes and reviews proper reserves for each claim based upon thorough investigation evaluation and experience maintaining appropriate reports to ensure current status of claims are clearly documented at all times.
• Provides direction to outside resources.
• Makes decisions guided by general instructions and practices requiring interpretation.
• Coordinates and collaborates with cross-functional specialists loss prevention legal counsel unit managers special investigations unit HR partners safety directors and fellow examiners to support accurate determination of injury mechanisms and case strategy.
• Makes recommendations to solve more complex problems.
• Recognizes problems or situations that are new or lack clear precedent.
• Finds solutions using a systematic multi-step approach.
• Develops improvements and innovations to enhance performance.
• Collaborates with all stakeholders involved in the claim lifecycle including policyholders agents claimants and internal partners.
• Handles regular contact with outside vendors.
• Travels on short notice for field work as required (e.g. scene investigations inspecting property losses).
• Performs special projects and other duties as assigned.

What are the must-have qualifications for a candidate

• A minimum of two years of experience with Workers Compensation claims.
• Strong understanding of industry practices standards and claims concepts.
• Ability to multitask and solve problems.
• Ability to identify and investigate potential fraud indicators including irregularities in medical treatment billing practices and reported injury details.
• Proficient oral and written communication skills.
• Strong negotiation and relationship-building skills.
• Analytical with the ability to exercise sound business judgment.
• Strong time management skills.
• Bachelors degree or related experience.

What will our ideal candidate have

• Prior experience managing Workers Compensation claims in several of our operating states is preferred (e.g. Alaska Illinois Iowa Michigan Minnesota New York South Dakota or Wisconsin).
• Experience handling claims across multiple jurisdictions and navigating differing state regulations is strongly preferred.
• AIC or AINS certification strongly preferred.
• Ability to manage the end-to-end claims process in alignment with client expectations corporate policies industry best practices and all statutory regulatory and ethical requirements.
• Proficient use of various core systems office and computer equipment and software packages.

Compensation overview

The full hiring range for this role is $59200 - $94000 annually. However the base pay offered may vary depending on the job-related knowledge skills credentials and experience of each candidate as well as other factors such as the scope and location of the role. Candidates looking for compensation outside of the posted range are encouraged to apply and will be considered based on their individual qualifications and / or may be considered for other positions.

Western National Insurance Group reserves the right to fill this position at a level above or below the level included in this posting.

Culture and Total Rewards

Western National has long been known as The Relationship Company and caring for our employees is part of that relationship commitment. We value connectiveness empowerment and accountability and we believe that our employees are our biggest asset.

Currently ranked as the 41st largest private company by revenue in Minnesota (Minneapolis/St. Paul Business Journal) Western National has earned accolades year-over-year as an employer of choice and garnered multiple awards for wellness in the workplace. Western National has also been named a Top Workplace by the Star Tribune for the past four consecutive addition the Group is consistently recognized as a Wards 50 property-and-casualty insurance company for its outstanding financial results.

Western National offers full-time employees a significant Total Rewards Package including:

• Medical insurance plan options and other standard employee benefits including dental insurance vision benefits life insurance disability insurance and more!
• Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA)
• 401(k) Plan (participants are eligible for 100% matching on the first 6% of their contributions)
• Wellbeing Program including onsite fitness studio
• Paid Time Off including holiday vacation and volunteer
• 100% company-paid tuition reimbursement for approved job-relevant coursework and access to The Institutes (Risk and insurance education)
• Paid parental leave
• Bonus opportunities

Western National believes in supporting balance between work and life by providing a flexible work environment which includes a variety of hybrid and remote work arrangements designed to balance individual job department and company needs.

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Western National provides employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.

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