Claims Examiner III

Markel; Cranston (RI); On-site; USD 83,000 - 171,000; Full time

Benefits offered by this job

Health Insurance

401(k) with employer match

Employee Stock Purchase Plan

PTO and holidays

Parental leave

Job summary

Markel is seeking a claims professional to resolve high-complexity workers' compensation claims across multiple jurisdictions. The role involves coverage analysis, investigations, and negotiation within authority, with travel to mediations and trials as needed.

The candidate will review policies, set reserves, and strive to return injured workers to work while upholding Fair Claims Practices and quality objectives.

Qualifications

• Bachelor's degree preferred; equivalent insurance experience may substitute.
• Insurance designation(s) preferred.
• Excellent written and verbal communication skills.
• Strong analytical, problem-solving, and organizational skills.
• Ability to deliver outstanding customer service and work in a team.
• Strong understanding of medical terminology preferred.
• Microsoft Office proficiency: Excel, Outlook, PowerPoint, Word.
• Commitment to continuous improvement.
• Ability to analyze complex coverage, liability, and medical management issues and make sound decisions.
• Strong negotiation and decision-making skills.

Responsibilities

• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Analyzes coverage and communicates coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Directs and monitors assignments to experts and outside counsel
• Evaluates information on coverage, compensability, and medical management to determine the extent of insured's exposure
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Focus on driving claims to a resolution with a focus of returning the injured back to work
• Evaluate, Negotiate and settle claim when appropriate
• Prepares reports by collecting and summarizing information
• Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives
• Participates in special projects or assists other team members as requested
• Attend all state specific trainings as scheduled
• Travel to mediations, trials, and conferences as required

Skills

Communication skills

Analytical skills

Team player

Negotiation

Medical terminology

Microsoft Office

Education

Bachelor's degree

Insurance designation

Tools

Excel

Outlook

PowerPoint

Word

Job description

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of high complexity and high exposure Workers Compensation claims in multiple jurisdictions. The position will have increased responsibility for decision making within their authority and work under general direction from their manager.

Job Responsibilities

• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Analyzes coverage and communicates coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Directs and monitors assignments to experts and outside counsel
• Evaluates information on coverage, compensability, and medical management to determine the extent of insured's exposure
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Focus on driving claims to a resolution with a focus of returning the injured back to work
• Evaluate, Negotiate and settle claim when appropriate
• Prepares reports by collecting and summarizing information
• Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives
• Participates in special projects or assists other team members as requested
• Attend all state specific trainings as scheduled
• Travel to mediations, trials, and conferences as required

Qualifications & Skills

• Bachelor's degree in a business-related field preferred; equivalent insurance industry experience may be substituted.
• Insurance designation(s) preferred.
• Excellent written and verbal communication skills.
• Strong analytical, problem-solving, organizational, and time management skills.
• Ability to deliver outstanding customer service and work effectively in a team environment.
• Strong understanding of medical terminology preferred.
• Intermediate proficiency in Microsoft Office applications, including Excel, Outlook, PowerPoint, and Word.
• Demonstrated commitment to continuous improvement and professional development.
• Ability to analyze complex coverage, liability, compensability, and medical management issues and make sound claim decisions.
• Strong negotiation and decision-making skills.

US Work Authorization

US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.

Pay Information

The salary range for this position is $82,500 - $171,450. The posted salary range reflects the lowest and highest base salary applicable to this role across our U.S. locations. Individual offers are determined based on geographic location, experience, qualifications, internal equity, and other job-related factors. As a result, the salary offered for a specific location will fall within a narrower range than the overall range displayed in this posting. This position may also be eligible to participate in the Company's annual incentive plan.

Who We Are

Markel Group (NYSE – MKL) a fortune 500 company with over 60 offices in 20+ countries, is a holding company for insurance, reinsurance, specialist advisory and investment operations around the world.

What’s In It For You

In keeping with the values of the Markel Style, we strive to support our employees in living their lives to the fullest at home and at work.

• We offer competitive benefit programs that help meet our diverse and changing environment as well as support our employees’ needs at all stages of life.
• All full-time employees have the option to select from multiple health, dental and vision insurance plan options and optional life, disability, and AD&D insurance.
• We also offer a 401(k) with employer match contributions, an Employee Stock Purchase Plan, PTO, corporate holidays and floating holidays, parental leave.

Markel is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of any protected characteristic. This includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law.

Should you require any accommodation through the application process, please send an e-mail to the [e-mail].

No agencies please.