Sr. Claims Service Representative

W.r. Berkley; Honolulu (HI); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Competitive compensation

Paid time off

Wellness benefits

Employer funded health savings account

Profit sharing

401(k)

Paid parental leave

Employee stock purchase plan

Tuition assistance and continuing ed.

Hybrid work schedule: 4 in 1

Job summary

W.r. Berkley is seeking a Sr Claims Service Representative to investigate and resolve high frequency, low severity workers’ compensation claims via telephone.

Hybrid work environment with 4 days in the office and 1 remote day, focused on data entry, reserves, and claim negotiation. Prior claims experience and strong customer service skills are essential to success.

Qualifications

• Two years related claims experience and/or training; or equivalent combination of education and experience.
• Proven customer service experience with strong customer orientation.
• Ability to successfully negotiate and resolve claims.
• Ability to interpret information, research and take steps to resolve problems.

Responsibilities

• Investigate and resolve high frequency, low severity workers’ compensation claims by telephone.
• Determine coverage, liability, damages, reserves and settle or deny claims.
• Enter claim data into systems for reporting and tracking.
• Re‑evaluate exposures and reserves during the life of the claim.
• Assist with administration and support to Senior Claims Adjusters.

Skills

Effective listening

Verbal communication

Written communication

Customer service

Education

Bachelor's degree preferred

AINS/AIC designation preferred

Tools

Microsoft Word

Excel

Outlook

Job description

Responsibilities

As a Sr Claims Service Representative, you'll develop skills and acquire the knowledge necessary to investigate and resolve high frequency, low severity workers’ compensation claims in a prompt and equitable manner via telephone investigation. You'll determine coverage, liability, damages, reserves and conclude claims through negotiation or denial of claim. We'll trust you to evaluate, assign, extract or input data for new claims assignments as well as provide administrative support to the Senior Claims Adjusters.

This role will be based in one of our three offices: Urbandale, IA; Luverne, MN; Lincoln, NE. A hybrid work schedule with 4 days in the office and 1 day remote where it makes sense to do so.

• Learn and become adept at examining policies, contracts and claim forms to determine coverage for routine matters.
• Investigate loss, evaluate exposures, and establish accurate reserves on high frequency, low severity commercial claims within established authority level.
• Deny or negotiate and settle claims.
• Correctly enter claim data into claim and related systems for reporting purposes.
• Re‑evaluate exposures and reserves during the life of the claim.
• Review new losses received by Claims Department to determine type and level of loss.
• Make initial contact with insureds and/or claimants to obtain additional information related to the claim if necessary.
• May assign claims to Claims staff based on analysis of exposure.
• Review data and create Excel spreadsheets to assist management with expenses, portal and goal management.
• Perform administrative support functions such as preparing routine correspondence, processing payments, completing routine forms for submission to State and National regulatory agencies and testing production system releases.
• Answer calls received from the Customer Experience Center and assist callers or direct call to appropriate claims staff.
• May assist agents, policyholders and claimants with questions related to claims handled by others on the line‑of‑business team.
• Participate in educational, coaching and mentoring opportunities to enhance claims adjusting skills and knowledge.
• Perform other related duties as assigned by management.

Qualifications

• Two years related claims experience and/or training; or equivalent combination of education and experience.
• Effective listening, verbal and written communication skills necessary to interact effectively with internal and external customers.
• Proven customer service experience with strong customer orientation.
• Ability to successfully negotiate.
• Ability to interpret information, evaluate, research and take steps to resolve problems.
• Proficient with Microsoft Word, Excel and Outlook.
• Ability to travel on an occasional basis to participate in business unit meetings and development opportunities.

What Makes You Stand Out

• Bachelor’s Degree preferred but not required.
• Demonstrates a willingness to embrace new systems, processes, technology and ideas.
• Acts with a sense of urgency and possess efficient planning, time management and organizational skills.
• Regularly and consistently demonstrates commitment to company values and guiding principles.
• Completion of or progress toward AINS, AIC or similar designations preferred.

Benefits

• Competitive compensation.
• Paid time off.
• Comprehensive wellness benefits and programs.
• Employer funded health savings account.
• Profit sharing.
• 401(k).
• Paid parental leave.
• Employee stock purchase plan.
• Tuition assistance and professional continuing education.
• Hybrid work schedule with 4 days in office, 1 remote.

The company is an equal opportunity employer.