Senior Claims Representative - Workers' Compensation

Penn National Insurance; Harrisburg (Dauphin County); Hybrid; USD 75,000 - 103,000; Full time

Job summary

Penn National Insurance is seeking experienced claims professionals to investigate, evaluate, and dispose of assigned workers' compensation claims with a goal of best-practices settlements within statutory guidelines.

Candidates may reside in approved markets and report to our Harrisburg, PA, Pittsburgh, PA or Waukesha, WI offices on a hybrid basis, enabling flexible in-person collaboration with teams and clients.

Qualifications

• Minimum of 5 years of workers' compensation claims handling experience.
• Strong understanding of tort and state laws applicable to claims and Unfair Claims Settlement Act.
• Good communication and interpersonal skills; ability to work independently or in a team.

Responsibilities

• Initiates self-development and training to improve skills in claims handling.
• Identify subrogation, contribution and salvage opportunities to recover payments.
• Communicate tactfully to support negotiations and positive company image.
• Handle complex coverage and liability issues; may attend civil proceedings or hearings.
• Develops claims files from assignment to disposition and maintains audit trails.
• Prepare and document claim actions to justify outcomes.
• Aim for best-practices settlements in dispositions.
• May participate or supervise a Claims Catastrophe Team as needed.
• Complete actions timely: verify coverages, set reserves, make contacts.
• Collaborate with Team Leader and Home Office on case strategy and disposition.

Skills

Negotiation

Business Acumen

Results Oriented

Time & Priority Management

Education

Associate's degree in Claims

IIA Certificate in General Insurance

Senior Claims Law Associate designations

Adjuster's license

Job description

These positions investigate, evaluate and dispose of assigned claims in a timely manner in order to achieve best practices type settlements within legal statutes, policy provisions and Company and/or client guidelines.

Candidates may reside in any of the approved hiring markets, provided they can report to our Harrisburg, PA, Pittsburgh, PA or Waukesha, WI office on a hybrid basis.

POSITION COMPETENCIES

• Business Acumen
• Negotiation
• Results Oriented
• Time & Priority Management

ESSENTIAL DUTIES

• Initiates self-development and training, in order to improve upon, maintain or acquire skills prescribed as promoting professional and personal growth in claims handling
• Properly identifies and pursues subrogation, contribution and salvage opportunities when available, in order to reduce or recover the amount of payment.
• Uses appropriate, tactful and complete communications, in order to ease negotiations, develop rapport and project a positive corporate and personal image.
• The ability to handle claims involving more complex coverage and liability issues; may also require attendance at civil proceedings or workers compensation hearings.
• Develops claims files from initial assignment to disposition.
• Prepares claim file documentation accurately and completely in order to justify all actions taken and to provide an effective audit trail.
• Achieves a best practices type settlement in the disposition of claims.
• May participate as a member of a Claims Catastrophe Team
• May act as a supervisor of a Claims Catastrophe Team
• Completes actions on a timely basis, such as verifying coverages, setting or adjusting reserves, making appropriate contacts.
• Collaborates with Team Leader, Manager and Home Office as necessary to develop case strategy, moving the investigation along and disposing of the claim, in order to keep management, claimants, insureds and other interested parties satisfied that effective efforts are being made toward claim settlement.
• Performs other duties as may be assigned by the Reporting managers listed above.

SPECIAL RELATIONSHIPS

• In Penn National Insurance, these positions report to the Team Leader; Team Leader or CSO Manager
• Direct contact with branch underwriting and/or claims service office personnel;
• Direct contact with Home Office claims personnel;
• Direct contact with agents, insureds, claimants, medical and legal professionals, appraisers and independent adjusters.

QUALIFICATIONS

Education/Credentials

• Continuing education in insurance-related courses such as IIA Certificate in General Insurance, Senior Claims Law Associate, and Associate in Claims courses and/or Workers’ Compensation courses (PA 10, 11, 12 ,and 13) preferred
• Associate's degree in Claims and/or Senior Claims Law Associate designations preferred
• Adjuster's license or be willing to obtain one as required

Experience

• Minimum of 5 years of experience in workers' compensation claims handling

Technical/Professional Knowledge

• Must have a good understanding of tort and state laws applicable to assigned claims, the Unfair Claims Settlement Act and insurance policy coverages and provisions
• Must have a good understanding of terminology applicable to assigned claims; i.e., medical, legal, automotive and construction terminology
• Good communication skills, both oral and written
• Good inter-personal skills
• Good analysis and evaluation skills
• Must have a strong sense of urgency
• Good PC skills, with an emphasis on Microsoft Office Products
• Good planning and organization skills
• Must be able to work independently as well as a member of a team

The compensation has been carefully determined by considering a variety of important factors, including skill sets, experience, training, and certifications. With these considerations in mind, the estimated hiring range is $75,000 - $103,000. Additionally, you may be able to participate in our annual incentive program, depending on eligibility under the plan.

JOB REQUIREMENTS (as required by ADA – Americans with Disabilities Act)

• This position is primarily a sedentary position that requires occasional standing and walking throughout the office environment.
• Must be able to see and effectively use a computer monitor.
• Must be able to operate a computer, keyboard and applicable printers and other general office equipment.
• Must be able to access and enter information accurately using automated systems.
• Must be able to hear and communicate via the telephone and/or monitoring devices to both internal and external clients.
• Must be able to present information to individuals and groups.
• Must be able to interpret and apply concepts that may or may not be based upon established guidelines.
• Must be able to maintain acceptable attendance and adhere to scheduled work hours.
• Must have a valid driver’s license and be able to operate a motor vehicle.
• Must be able to travel, with overnight stays required.