Senior Workers’ Comp Claims Specialist

Berkley Small Business Solutions (a Berkley Company); San Diego (CA); Remote; USD 75,000 - 110,000; Full time

Benefits offered by this job

Health, dental, vision, life insurance

401(k) and profit-sharing

Paid time off

Wellness programs

Job summary

BerkleyNet in California is seeking a Senior Claims Representative to manage investigation, evaluation and settlement of workers’ compensation claims across jurisdictions. You will interview injured workers, witnesses and policyholders, set reserves, document details in the claims system and issue payments.

The role involves negotiating settlements within authority, coordinating medical treatment, and staying current with regulatory requirements.

Qualifications

• Bachelor's degree or equivalent insurance industry work experience.
• AIC, ARM, CCP or CPCU designation is preferred.

Responsibilities

• Investigate workers’ compensation claims by interviewing injured workers, witnesses and policyholders.
• Calculate and set timely financial reserves and manage reserve adequacy throughout the claim lifecycle.
• Record and code demographics, job and accident information in the claims system; file forms as required.
• Issue timely payments to injured workers, medical providers, and service vendors.
• Coordinate and manage medical treatment to ensure timely rehabilitation.
• Negotiate settlements within designated authority with injured workers and attorneys.
• Serve as SME on Workers’ Compensation Act, adjudication, and regulatory compliance.
• Identify and manage subrogation and recovery opportunities.
• Communicate claim activity and status to policyholders and others professionally.

Skills

Communication skills

Time management

Analytical thinking

Conflict resolution

Relationship building

Discretion

Detail oriented

Education

Bachelor's degree or equivalent

Insurance designation preferred (AIC/ARM/CCP/CPCU)

Tools

Claims management system

Job description

BerkleyNet in California is seeking a Senior Claims Representative to manage investigation, evaluation and settlement of workers’ compensation claims across jurisdictions. You will interview injured workers, witnesses and policyholders, set reserves, document details in the claims system and issue payments.

The role involves negotiating settlements within authority, coordinating medical treatment, and staying current with regulatory requirements.