Senior Claims Examiner – Workers’ Comp (High-Impact)

Markel; Cranston (RI); On-site; USD 83,000 - 171,000; Full time

Benefits offered by this job

Health Insurance

401(k) with employer match

Employee Stock Purchase Plan

PTO and holidays

Parental leave

Job summary

Markel is seeking a claims professional to resolve high-complexity workers' compensation claims across multiple jurisdictions. The role involves coverage analysis, investigations, and negotiation within authority, with travel to mediations and trials as needed.

The candidate will review policies, set reserves, and strive to return injured workers to work while upholding Fair Claims Practices and quality objectives.

Qualifications

• Bachelor's degree preferred; equivalent insurance experience may substitute.
• Insurance designation(s) preferred.
• Excellent written and verbal communication skills.
• Strong analytical, problem-solving, and organizational skills.
• Ability to deliver outstanding customer service and work in a team.
• Strong understanding of medical terminology preferred.
• Microsoft Office proficiency: Excel, Outlook, PowerPoint, Word.
• Commitment to continuous improvement.
• Ability to analyze complex coverage, liability, and medical management issues and make sound 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 skills

Team player

Negotiation

Medical terminology

Microsoft Office

Education

Bachelor's degree

Insurance designation

Tools

Excel

Outlook

PowerPoint

Word

Job description

Markel is seeking a claims professional to resolve high-complexity workers' compensation claims across multiple jurisdictions. The role involves coverage analysis, investigations, and negotiation within authority, with travel to mediations and trials as needed.

The candidate will review policies, set reserves, and strive to return injured workers to work while upholding Fair Claims Practices and quality objectives.