Remote Senior Workers' Comp Claims Specialist

West Bend Mutual Insurance Company; West Bend (WI); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical & Prescription Insurance

Health Savings Account

Dental Insurance

Vision Insurance

Short and Long Term Disability

401(k) Plan with Company Match

Paid Time Off

Job summary

West Bend Mutual Insurance Company seeks a Claims Representative (Workers Comp) to take ownership of complex workers comp claims from initial investigation through resolution. This active desk role requires strong judgment, organization, and the ability to prioritize a busy workload with minimal supervision.

You will research policy language, evaluate coverage, liability, and settlements, and collaborate with attorneys and internal partners to achieve fair resolutions.

Qualifications

• Bachelor's degree in Business, Insurance, or a related field.
• Associate in Claims (AIC) designation.
• Associate in General Insurance (AINS) designation.
• CPCU coursework or other relevant insurance education or continuing professional development.

Responsibilities

• Take ownership of complex workers comp claims from initial investigation through resolution.
• Research policy language to develop well-supported coverage decisions.
• Conduct thorough investigations and evaluate liability, damages, reserves, and settlement strategy.
• Negotiate effectively with insureds, claimants, attorneys, and other parties.
• Oversee litigated files and collaborate with counsel on resolutions.
• Proactively manage a busy caseload with accurate reserves and timely follow-up.
• Present complex claims to Committee with clear recommendations.
• Collaborate with teammates and internal partners to resolve claims.
• Serve as a resource and mentor on the Claims team.
• Deliver high-level customer service while meeting audit standards.

Skills

Complex claims handling

Communication

Time management

Team collaboration

Investigation

Negotiation

Independent decision-making

Education

Bachelor's in Business/Insurance or related field

AIC designation

AINS designation

CPCU coursework/insurance education

Tools

Claims software

Job description

West Bend Mutual Insurance Company seeks a Claims Representative (Workers Comp) to take ownership of complex workers comp claims from initial investigation through resolution. This active desk role requires strong judgment, organization, and the ability to prioritize a busy workload with minimal supervision.

You will research policy language, evaluate coverage, liability, and settlements, and collaborate with attorneys and internal partners to achieve fair resolutions.