Senior Workers' Compensation Claims Representative

Acadia Insurance (a Berkley Company); Westbrook (ME); On-site; USD 90,000 - 105,000; Full time

Benefits offered by this job

Base salary 90k–105k

Annual discretionary bonus

Comprehensive benefits

Job summary

Acadia Insurance, a Berkley Company, is seeking a Senior Workers’ Compensation Claims Representative in the Northeast region. You will investigate, evaluate and resolve claims following company standards and state regulations while maintaining top-tier customer service.

The role requires 5 years of NH/Maine workers’ compensation claims experience, a valid NH WC adjuster license, and strong negotiation, communication, and organizational skills.

Qualifications

• 5 years of New Hampshire and/or Maine Workers’ Compensation Lost Time claims handling experience.
• Valid NH WC adjuster license.
• Advanced professional insurance coursework (i.e., AIC, CPCU) preferred.
• Valid Driver’s License required.

Responsibilities

• Investigate, evaluate and resolve workers’ compensation claims in accordance with company standards and state requirements.
• Analyze facts of loss to reach appropriate decisions and communicate compensability decisions.
• Prepare written communications to insureds, claimants, attorneys and agents professionally.
• Conduct detailed claim investigations including site visits and witness interviews when appropriate.
• Negotiate settlements in good faith and manage litigated files to resolution with defense counsel.

Skills

Negotiation

Claims resolution

Written communication

Verbal communication

Organization

Education

Bachelor’s degree

Insurance coursework (AIC/CPCU)

Tools

MS Word

Excel

Job description

Company Details

Acadia Insurance is a regional property casualty insurer with offices throughout the Northeast. As a member of W.R. Berkley Corporation (NYSE: WRB), one of the largest property casualty insurance holding companies in the United States, our financial strength and integrity are two of the main reasons why Independent Agents place business with us. Acadia is rated A+ (Superior) by A.M. Best, with an A+ claim paying ability rating by Standard & Poor’s.

At Acadia, we value our employees, our customers and our communities. Employees at Acadia are part of a progressive company where everyone can make a difference. We promote an inclusive environment which encourages continuous learning and the chance to grow and develop.

Company URL: https://www.acadiainsurance.com/

Responsibilities

The Senior Workers’ Compensation Claims Representative is responsible for investigating, evaluating, and resolving assigned workers’ compensation claims in accordance with company standards, procedures, and state regulatory requirements.

• Investigate, evaluate and resolve claims in accordance with company standards, procedures, and state regulatory requirements.
• Analyze and determine specific facts of loss to reach appropriate decisions and effectively communicate the company’s compensability decisions.
• Compose a variety of written communications to insureds, claimants, attorneys and agents in a professional and error-free manner.
• Conduct detailed, comprehensive claim investigations including possible on-site scene examinations and in-person witness interviews when appropriate and necessary.
• Evaluate and document exposure to ensure accurate and timely reserves; immediately escalation to management cases with significant exposure.
• Negotiate effectively and in good faith to achieve fair and accurate claim settlements.
• Proactively manage litigated claim files from inception to closure, including collaboration with defense counsel to determine and execute an appropriate plan of action; bring litigated cases to resolution either by negotiated settlement or hearing decisions, as appropriate.
• Retain vendors to achieve appropriate claim outcomes while remaining mindful of loss adjustment expenses.
• Manage assigned workloads effectively to achieve quality and quantity production goals while providing superior customer service.
• Effectively present cases in roundtable discussions with peers and members of management at all levels.
• Appropriately and clearly document all notes and file activity in a paperless claim system; compose detailed periodic reports including claim summary reports and large loss notifications.
• Communicate with other departments regarding developments on specific claim files as well as overall claim trends relevant to Acadia’s business.
• Maintain a strong relationship and frequent communication with Acadia’s agency partners.
• Work proficiently with various computer programs including MS Word, Excel, and other applications used in the claim handling process.
• Attend internal and external seminars and other training events and provide feedback to peers and/or members of management.
• Obtain all required state adjuster licenses and maintain them as needed by complying with continuing education requirements.
• Pursuit of industry-related professional designations is encouraged.
• Perform other duties as assigned.

Qualifications

• 5 years of New Hampshire and/or Maine Workers’ Compensation Lost Time claims handling experience.
• Valid NH WC adjuster license.
• Excellent organizational skills with the ability to handle multiple tasks and effectively prioritize workload.
• Demonstrated depth in negotiation and claims resolution skills.
• Strong computer skills and ability to work with multi-faceted systems.
• Ability to effectively and independently manage a complex workload while exhibiting very sound judgment.
• Excellent written and verbal communication skills.
• Demonstrated ability to develop and maintain relationships with agents and other departments while exemplifying superior teamwork.
• Advanced professional insurance coursework (i.e., AIC, CPCU) or completion of other insurance-related classes is preferred.
• Valid Driver’s License is required.
• The Company is an equal employment opportunity employer.

Education Requirement

• Bachelor’s degree (B.A.) and a minimum of 5 years of related experience and/or training, or an equivalent combination of education and experience.

Additional Company Details

We do not accept unsolicited resumes from third party recruiting agencies or firms.

The company offers a competitive compensation plan and robust benefits package for full time regular employees including:

• Base Salary Range: 90k-$105k
• Eligible to participate in annual discretionary bonus
• Benefits include: Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit-sharing plans

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role