Senior Workers' Comp Claims Examiner - Complex

Markel; Henderson (AL); Hybrid; USD 82,000 - 171,000; Full time

Benefits offered by this job

401(k) with employer match

Employee Stock Purchase Plan

Paid time off (PTO)

Sick/holidays and floating holidays

Parental leave

Job summary

Markel is seeking a qualified Claims Examiner to resolve high-complexity Workers' Compensation claims across multiple jurisdictions. You will operate with increasing decision-making authority under supervision and collaborate with internal teams and outside counsel.

The role includes travel to mediations, trials, and conferences as required. The candidate should have a business-related degree (or equivalent insurance experience), California Claims Examiner Certification, strong communication,

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

Customer service

Medical terminology

Microsoft Office

Negotiation skills

Decision making

Education

Bachelor's degree (preferred)

California Claims Examiner Certification

Tools

Microsoft Excel

Outlook

Word

Job description

Markel is seeking a qualified Claims Examiner to resolve high-complexity Workers' Compensation claims across multiple jurisdictions. You will operate with increasing decision-making authority under supervision and collaborate with internal teams and outside counsel.

The role includes travel to mediations, trials, and conferences as required. The candidate should have a business-related degree (or equivalent insurance experience), California Claims Examiner Certification, strong communication,