Remote Complex Workers’ Comp Claims Expert

biBerk Business Insurance; Fully; Remote; CHF 78,000 - 95,000; Full time

Benefits offered by this job

Medical, vision, disability and life

PTO and holidays

401(k) with company match

Tuition reimbursement

Wellness programs

Job summary

biBerk Business Insurance is seeking an experienced claims specialist to handle highly complex Workers’ Compensation claims in a remote role. The candidate will manage a challenging caseload, establish reserves, and collaborate with senior leadership to drive settlements and strategy across multiple jurisdictions.

The role requires an active adjuster license, 10+ years of WC claims experience, and excellence in communication and negotiation.

Qualifications

• Active adjuster license is required.
• 10+ years of experience handling complex workers’ compensation claims.
• Excellent organizational, leadership, communication and time management skills.
• Experience with structured settlements and Medicare Set-Asides.
• Ability to work in a fast-paced, collaborative, virtual office environment.
• Strong analytical, organizational, and time management skills.

Responsibilities

• Investigate coverage, determine compensability, and manage a high-exposure WC claims caseload.
• Proactively establish and update reserves throughout the life of the claim.
• Resolve claims within authority and make independent recommendations.
• Participate in reserving, pricing and strategy discussions with leadership.
• Collaborate with outside defense counsel to manage litigated files.
• Coordinate with medical providers to ensure timely treatment and bill submission.
• Ensure compliance with state and federal WC regulations.
• Provide excellent customer service to policyholders, agents, injured workers and vendors.
• Identify subrogation potential and SIU involvement when needed.
• Train new team members and act as a technical resource.

Skills

Active adjuster license

10+ years WC claims experience

Strong negotiation

Communication skills

MS Word

Excel

Education

BA/BS degree

AIC, SCLA, CPCU or other designation a plus

Tools

MS Word

Excel

Job description

biBerk Business Insurance is seeking an experienced claims specialist to handle highly complex Workers’ Compensation claims in a remote role. The candidate will manage a challenging caseload, establish reserves, and collaborate with senior leadership to drive settlements and strategy across multiple jurisdictions.

The role requires an active adjuster license, 10+ years of WC claims experience, and excellence in communication and negotiation.