Claims Representative I

Sentry Insurance Group; Juneau (AK); Hybrid; USD 60,000 - 85,000; Full time

Benefits offered by this job

Hybrid work model

Meal Subsidy

401(k) with match

Tuition Reimbursement

Paid Time Off

Health and Wellness benefits

Sentry Foundation gift matching

Job summary

Sentry Insurance Group in Westford, MA, is hiring a Workers’ Comp Claims Representative to support policyholders and ensure quality claim service. The role focuses on analyzing claims, coordinating return-to-work, and negotiating settlements with appropriate authority.

Key responsibilities include preparing settlements, directing cases to closure, and maintaining professional communication with claimants and clients.

Qualifications

• Bachelor’s degree preferred or related work experience.
• Knowledge of insurance policies and medical terminology helpful.
• Ability to make sound decisions while using good judgment in evaluating claims.
• Effective oral and written communication skills.
• Ability to maintain highly confidential information.
• Ability to review and interpret complex and detailed documents such as contracts, medical reports, and insurance regulations.
• Ability to multi-task, prioritize, and remain organized.
• Effective and efficient at working a computer.

Responsibilities

• Analyze claims, set reserves, determine compensability, pay benefits, and settle claims with established dollar authority.
• Develop and manage workers’ compensation claims action plans to a resolution, coordinate return-to-work efforts, and approve claim payments.
• Prepare claims for settlement and negotiate a settlement with the best outcome.
• Manage and direct all cases to closure in the most efficient and effective way possible.
• Communicate claim action and processing with claimant and client in a professional and timely manner.

Skills

Customer service

Communication

Decision making

Confidentiality

Documentation review

Multi-tasking

Computer proficiency

Education

Bachelor’s degree or related work experience

Job description

Full job description Start your career at Sentry! Join our Workers’ Comp Claims team and support our policyholders, who with your efforts, view us as a valuable partner. Our Claims Representatives ensure the delivery of quality claim service to our customers, the injured worker, and other parties to the claim while protecting the assets of Sentry. This position will be located at the Westford, MA office.

What You’ll Do

• Analyze claims, set reserves, determine compensability, pay benefits, and settle claims with established dollar authority.
• Develop and manage workers’ compensation claims action plans to a resolution, coordinate return-to-work efforts, and approve claim payments.
• Prepare claims for settlement and negotiate a settlement with the best outcome.
• Manage and direct all cases to closure in the most efficient and effective way possible.
• Communicate claim action and processing with claimant and client in a professional and timely manner.

What it Takes

• Bachelor’s degree preferred or related work experience.
• Knowledge of insurance policies and medical terminology helpful.
• Ability to make sound decisions while using good judgment in evaluating claims.
• Effective oral and written communication skills.
• Ability to maintain highly confidential information.
• Ability to review and interpret complex and detailed documents such as contracts, medical reports, and insurance regulations.
• Ability to multi-task, prioritize, and remain organized.
• Effective and efficient at working a computer.

What You’ll Receive

• Flexibility through a scheduled Hybrid work model. Monday and Friday work from home if you choose to, Tuesday through Thursday you’ll work in office.
• An in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office.
• Meal Subsidy available for associates who report to an office.
• 401(k) plan with a dollar for dollar match on your first eight percent, plus immediate vesting.
• Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program.
• Generous Paid-Time Off plan and Volunteer-Time off.
• Group Medical, Dental, Vision, Life insurance, Parental leave, and Health and Wellness benefits.
• Well-being and Employee Assistance programs.
• Sentry Foundation gift matching program to encourage charitable giving.

About Sentry: We take great pride in making Forbes’ list of America’s Best Midsize Employers. A lot of different factors go into that honor, many of which contribute to your job satisfaction. Our bright future is built on a long track record of success. We got our start in 1904 and have been helping businesses succeed and protect their futures ever since. Because of the trust placed in us, we’re one of the largest and financially strongest mutual insurance companies in the United States. We’re rated A+ by A.M. Best, the industry's leading rating authority. Our headquarters is in Stevens Point, Wisconsin, with offices located throughout the United States. From sales to claims, and information technology to marketing, we enjoy a rewarding and challenging work environment with opportunities for ongoing professional development and growth.

Sentry is an Equal Opportunity Employer. It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.