Senior Claims Examiner, Complex Workers' Comp

Markel; Henderson (NV); On-site; USD 82,000 - 171,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) with employer match

Employee Stock Purchase Plan

PTO and holidays

Parental leave

Job summary

Markel in the United States seeks a qualified examiner to resolve high-complexity Workers' Compensation claims across jurisdictions. You will review policies for coverage, direct investigations, and coordinate experts and counsel while maintaining fair claims practices.

The role requires excellent communication, strong analytical and negotiation skills, and the ability to make sound, timely decisions. A related degree and certification are preferred, with opportunities for growth and occasional

Qualifications

• 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.

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

Skills

Communication skills

Analytical thinking

Time management

Negotiation skills

Customer service

Team player

Medical terminology

MS Office

Education

Bachelor's degree in business-related field

California Claims Examiner Certification

Tools

Microsoft Office (Excel, Outlook, Word)

Job description

Markel in the United States seeks a qualified examiner to resolve high-complexity Workers' Compensation claims across jurisdictions. You will review policies for coverage, direct investigations, and coordinate experts and counsel while maintaining fair claims practices.

The role requires excellent communication, strong analytical and negotiation skills, and the ability to make sound, timely decisions. A related degree and certification are preferred, with opportunities for growth and occasional