Senior Workers' Compensation Claims Specialist

Key Risk (a Berkley Company); Atlanta (GA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Annual discretionary bonus

Health & other benefits

401(k) with profit sharing

Job summary

Key Risk (a Berkley Company) is seeking a Workers' Compensation Claims Representative III to analyze and manage complex claims, review coverage, determine compensability, and negotiate settlements on behalf of policyholders.

This role requires 3–5 years of claims management experience, an adjuster license or plan to obtain it, and strong communication, negotiation, and analytical skills. Travel up to 10% is expected; the position is based in High Point, NC or nearby.

Qualifications

• 3-5 years of workers' compensation claims management experience.
• Adjuster license strongly desired or ability to obtain license within six months.
• In depth knowledge of appropriate insurance principles and laws of workers' compensation, preferably jurisdiction specific.
• Strong written and verbal communication skills.
• Strong interpersonal, time management and organizational skills.
• Strong negotiation skills.
• Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail.
• Ability to travel for business purposes, approximately less than 10%

Responsibilities

• Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
• Negotiates settlement of claims up to designated authority level and makes claims payments.
• Calculates and assigns timely and appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level.
• Develops and manages claims through well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
• Prepares necessary state filings within statutory limits.
• Actively manages the litigation process; ensures timely and cost-effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
• Frequently communicates with all appropriate parties involved with the claim.
• Maintains professional client relationships.
• Actively executes appropriate claims activities to ensure consistent delivery of quality claims services

Skills

Written and Verbal Communication

Interpersonal Skills

Time Management

Organizational Skills

Negotiation Skills

Critical Thinking

Travel Availability

Education

BA/BS Degree

Job description

Key Risk (a Berkley Company) is seeking a Workers' Compensation Claims Representative III to analyze and manage complex claims, review coverage, determine compensability, and negotiate settlements on behalf of policyholders.

This role requires 3–5 years of claims management experience, an adjuster license or plan to obtain it, and strong communication, negotiation, and analytical skills. Travel up to 10% is expected; the position is based in High Point, NC or nearby.