Claims Representative I (Workers' Compensation)

Society Insurance; Fond du Lac (WI); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Salary with bonus plan

Health insurance

401(k) retirement plan

Flexible scheduling

PTO

Job summary

Society Insurance in Wisconsin seeks a Claims Representative I (Workers’ Compensation). You will handle mildly complex claims, determine coverage, settle with claimants, review records, and coordinate with experts as needed.

This exempt, full‑time position supports a hybrid work model with home office and remote options in multiple states, offering competitive benefits, ongoing training, and opportunities to build professional expertise within the Claims department.

Qualifications

• Bachelor’s Degree in business or related field.
• OR 3+ years of claims handling experience as determined by Society Insurance.
• OR 5+ years of knowledge in the property & casualty insurance industry.
• Familiarity with PC applications including word processing, Internet, spreadsheets, and e-mail software.
• Ability to obtain and maintain proper licensing prior to handling a state that requires it.
• Valid driver’s license and a satisfactory driving record as determined by Society Insurance.
• Prior workers’ compensation indemnity experience is highly desirable.
• Professional insurance designations are highly desirable.

Responsibilities

• Handles and settles mildly complex claims by determining insurance carrier’s liability; reaching agreement with claimants/injured workers according to policy provisions and authority level; and handling subrogation.
• Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants/injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting with experts when appropriate.
• Resolves questionable claims by investigating and comparing claims information with evidence.
• Ensures company guidelines and procedures are followed during investigations and in the handling of discovery and settlement.
• Ensures proper file documentation by complying with claims handling guidelines and state requirements.
• Prepares reports by collecting, analyzing, and summarizing claim information.
• Develops and maintains professional, technical knowledge and expertise in a specified line(s) of business through training courses and participating in continuing education coursework/classes.
• Contributes to team effort by participating in determining department investigation guidelines; and providing feedback to underwriting as needed.

Skills

Communication

Relationship building

Negotiation

Composure under pressure

Accountability

Analytical thinking

Investigative approach

Curiosity

Education

Bachelor’s Degree in business or related field

3+ years claims handling experience

5+ years knowledge in P&C insurance

Tools

MS Office

Internet

Email

Spreadsheets

Job description

Job Information

Job Title: Claims Representative I (Workers’ Compensation)

Home Department: Claims

Employment Status: Exempt; Full-time

Schedule: 40 hours/week with Flexible Scheduling Opportunities

Position Location: Home Office, Hybrid, and Remote Opportunities in CO, GA, IL, IN, IA, MN, TN, TX, & WI

Overview

Protecting our policyholders’ dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society.

About The Role

• Handles and settles mildly complex claims by determining insurance carrier’s liability; reaching agreement with claimants/injured workers according to policy provisions and authority level; and handling subrogation.
• Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants/injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting with experts when appropriate.
• Resolves questionable claims by investigating and comparing claims information with evidence.
• Ensures company guidelines and procedures are followed during investigations and in the handling of discovery and settlement.
• Ensures proper file documentation by complying with claims handling guidelines and state requirements.
• Prepares reports by collecting, analyzing, and summarizing claim information.
• Develops and maintains professional, technical knowledge and expertise in a specified line(s) of business through training courses and participating in continuing education coursework/classes.
• Contributes to team effort by participating in determining department investigation guidelines; and providing feedback to underwriting as needed.

About You

• You enjoy communicating and building relationships with others.
• You are composed, cool under pressure, and can negotiate without damaging relationships.
• You hold yourself accountable and act in accordance with rules and regulations.
• You enjoy analyzing, investigating, and using the facts to make decisions.
• You are naturally curious and have a desire to know more.
• You apply an investigative approach to identifying facts and evaluating evidence.

What It Will Take

• Bachelor’s Degree in business or related field
• OR 3+ years of claims handling experience involving the exercise of discretionary decision-making as determined by Society Insurance
• OR 5+ years of knowledge in the property & casualty insurance industry

• Familiarity with PC applications including word processing, Internet, spreadsheets, and e-mail software.
• Ability to obtain and maintain proper licensing prior to handling a state that requires it.
• Valid driver’s license and a satisfactory driving record as determined by Society Insurance.
• Prior workers’ compensation indemnity experience highly desirable.
• Professional insurance designations highly desirable.

What Society Can Offer

• Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance
• Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan
• Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options
• Education: Career Coaching; company-paid courses; student loan and tuition reimbursement
• Community: Charitable Match; paid volunteer time; team sponsorships
• Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more

Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug‑free workplace.