Senior Workers' Compensation Claims Examiner

Berkley Risk (a Berkley Company); McKinney (TX); On-site; USD 90,000 - 100,000; Full time

Benefits offered by this job

Health benefits

401(k) & profit sharing

Paid time off

Job summary

Berkley Risk (a Berkley Company) is seeking a detail-oriented Workers' Compensation Claims Analyst to manage complex caseloads, including disability cases and litigation support. You will ensure compliance with regulations and collaborate with clients, legal counsel, and healthcare professionals to resolve claims efficiently.

The role requires strong analytical skills, excellent customer service, and proficient PC use within a claims processing environment. Occasional travel may be required.

Qualifications

• Demonstrated working knowledge of workers’ compensation administration rules/laws.
• Excellent communication and presentation skills.
• Must be able to interface with clients, legal counsel, health care professionals, etc.
• Good math and analytical ability.
• Excellent customer service skills.
• Basic PC skills and a working knowledge of Windows environment. Experience with a client/server based claims processing system.

Responsibilities

• Investigate claims and decide on compensability and general claims management for assigned files.
• Document claim handling activities; create and document action plans.
• Establish appropriate case reserves.
• Manage medical treatment and disability while helping the injured worker return to work.
• Comply with performance guidelines.
• Identify loss trends and communicate to supervisor/clients.
• Use diary system to issue indemnity payments and manage claims.
• Investigate and manage subrogation and settlements.
• Handle coverage B or conflict-of-interest cases as assigned.
• Address customer complaints professionally.
• Participate in client claim reviews as scheduled or requested.
• May perform other functions as assigned.

Skills

Workers' comp rules

Communication

Client interface

Math & analytics

Customer service

Windows pc skills

Education

BA/BS + 3 years experience

Alternative credential path

Tools

Claims processing system

Job description

Berkley Risk (a Berkley Company) is seeking a detail-oriented Workers' Compensation Claims Analyst to manage complex caseloads, including disability cases and litigation support. You will ensure compliance with regulations and collaborate with clients, legal counsel, and healthcare professionals to resolve claims efficiently.

The role requires strong analytical skills, excellent customer service, and proficient PC use within a claims processing environment. Occasional travel may be required.