Claims Operations Associate

W. R. Berkley Corporation; High Point (NC); On-site; USD 40,000 - 56,000; Full time

Job summary

Key Risk, part of the W. R. Berkley Corporation, seeks a motivated Claims Associate to manage low-exposure workers' compensation claims and learn the applicable laws while delivering outstanding service to clients.

You will communicate with employers, adjusters and providers; responsibilities include reserving for medical-only claims, logging notes, and supporting subrogation and workflow needs. No prior experience required.

Qualifications

• 0-2 years of workers' compensation claims experience
• Adjuster license strongly desired or ability to obtain license within six months
• Knowledge of workers' compensation laws and insurance principles
• Strong verbal and written communication
• Strong interpersonal, time management and organizational skills
• Strong negotiation skills
• Proven critical thinking with attention to detail
• Ability to travel for business purposes, approx. <10%

Responsibilities

• Maintain good lines of communication with employers, adjusters, and providers
• Discuss with an employer issues related to an injured worker's return to work status
• Request medical notes, billing information, and other data to determine payment appropriateness
• Timely and accurate reserve for medical-only claims
• Document communications in the claim log notes
• Discuss payment status with employees and providers
• Assist in unit communications with customers, providers and injured employees
• Enter medical notes into claim log and index images as needed
• Identify potential subrogation claims and notify supervisor

Education

BA/BS Degree

Job description

Company Details

With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results.

All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P.

For further information about Key Risk please visit www.KeyRisk.com

The company is an equal opportunity employer.

Responsibilities

Key Risk is looking for an enthusiastic Claims Associate professional who will be responsible for the management of low exposure workers' compensation claims. The Claims Associate will be responsible for learning workers compensation laws and providing outstanding service to our clients. This is an entry-level position with no experience necessary

Key functions include but are not limited to the following:

• Maintain good lines of communication with employers, adjusters, and providers
• Discuss with an employer, issues relative to an injured workers' return to work status
• Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only
• Timely and accurately reserve for medical only claims assigned
• Document relevant written and oral communication received relative to medical-only claims in the log notes
• Discuss with an employee, issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued
• Assist in the management of communication of the unit with customers, providers and injured employees
• Enter medical notes into claim log as required
• Index images as neededIdentify potential subrogation claims and notify appropriate supervisor

Qualifications

Education Requirement

BA/BS DegreeQualifications:

Include necessary skills/experience and core competencies required

• 0-2 years of workers compensation claims experience
• Adjuster license strongly desired or ability to obtain license within six months
• Knowledge of appropriate insurance principles and laws of workers' compensation, preferably jurisdiction specific.
• Strong verbal and written communication
• Strong interpersonal, time management and organizational skills.
• Strong negotiation skills.
• Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail.
• Ability to perform with a sense of urgency.
• Ability to work both independently and within a team environment.
• Ability to travel for business purposes, approximately less than 10%.

Additional Company Details

We do not accept any unsolicited resumes from external recruiting agencies or firms.

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

Sponsorship Details

Sponsorship not Offered for this Role