Claims Examiner III

markelcorp; Henderson (NV); Hybrid; USD 82,000 - 171,000; Full time

Job summary

Markel Group is seeking a qualified Workers' Compensation Claims Examiner to resolve high-complexity, high-exposure claims across jurisdictions. This role carries increased decision-making authority under supervision and requires collaboration with the manager and team.

You will review coverage, set reserves within authority, negotiate settlements, and support medical management and investigations while traveling to mediations and trials as needed.

Qualifications

• Bachelor's degree in a business-related field or equivalent insurance industry experience.
• California Claims Examiner Certification is preferred.
• Strong written and verbal communication skills are essential.
• Analytical, problem-solving, organizational and time management abilities are required.
• Ability to deliver outstanding customer service and work in a team environment.
• Knowledge of medical terminology is advantageous.
• Proficiency with MS Office applications is required.

Responsibilities

• Confirms coverage of claims by reviewing policies and documents submitted in support of claims.
• Analyzes coverage and communicates coverage positions.
• Conducts investigations 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 insured exposure.
• Sets reserves within authority or makes recommendations to the manager.
• Focuses on resolving claims with return-to-work objectives.
• Negotiates and settles when appropriate.
• Prepares reports by collecting and summarizing information.
• Attends state trainings and travels to mediations, trials, and conferences.

Skills

Claims analysis

Negotiation

Decision making

Communication

Team collaboration

Medical terminology

Time management

Education

Bachelor's degree in business-related field

California Claims Examiner Certification

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

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.
• California Claims Examiner Certification.
• 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, 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.

#LI-Hybrid

#LI-SY

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 $82,250 - $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.

We're all about people | We win together | We strive for better

We enjoy the everyday | We think further

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.

Are you ready to play your part?