WC Claims Examiner

W. R. Berkley Corporation; Saint Paul (MN); On-site; USD 55,000 - 65,000; Full time

Benefits offered by this job

Health, Dental, Vision

401(k) & Profit Sharing

Paid Time Off

Job summary

W. R. Berkley Corporation seeks a workers’ compensation claims professional in Minnesota to adjudicate and investigate claims, including medical-only, lost-time and litigated files.

You will manage reserves, subrogation, and indemnity payments while coordinating with employers, claimants, and regulatory agencies. The role requires 1–2 years of claims processing experience, strong math/analytical skills, and excellent communication and customer service.

Qualifications

• 1–2 years minimum workers’ compensation claim processing experience.
• Experience must include handling medical-only, lost-time and litigated claims.
• Demonstrated working knowledge of workers’ compensation administration rules/laws.
• Good to excellent math and analytical ability.
• Good to excellent oral and written communication skills.
• Excellent customer service skills.

Responsibilities

• Investigate and manage all types of workers’ compensation files within claim-handling guidelines.
• Initiate return-to-work discussions with employers and effect return-to-work for injured workers.
• Establish timely and appropriate case reserves.
• Investigate and manage subrogation and negotiate settlements.
• Use automated diary system to issue indemnity benefits and track payments.
• Accurately calculate and pay wage loss and other benefits.
• Coordinate rehabilitation and monitor costs and outcomes.
• Document action plans and evaluations for claim resolution.
• Maintain organized electronic files and communicate with clients and state agencies.

Skills

Claim processing

Analytical ability

Communication skills

Customer service

Education

College degree or relevant experience

Job description

Company Details

We’re a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.

Responsibilities

To perform workers’ compensation claims adjudication and investigation. Responsible for all technical aspects of claim management for assigned claims including compliance with all established performance guidelines.

• Properly investigate and handle all types of workers’ compensation files including lost time, litigation and long-term exposure within predetermined claim-handling guidelines.
• Initiate return-to-work discussions with the employer and effect return-to-work for the injured worker.
• Establish timely and appropriate case reserves.
• Investigate and manage subrogation and negotiate settlements.
• Use automated diary system to issue indemnity benefits and provide claim management.
• Accurately calculate and pay wage loss and other benefits.
• Assign rehabilitation and monitor costs and outcomes.
• Document all action plans and evaluations for claim resolution.
• Maintain organized electronic files.
• Interact with clients to establish/improve communication and service capabilities.
• Interact and communicate with state agencies, attorneys and other providers.
• Address customer complaints and inquiries in an exemplary and professional manner.
• Achieve specific performance outcomes related to quality and quantity of work as established by management.
• Provide cost containment for individual claim and overall claim costs for account to achieve account profitability.
• Define medical and rehabilitation payment parameters staff.
• May perform other functions as assigned.

Qualifications

• 1 – 2 years minimum workers’ compensation claim processing experience.
• Experience must include handling of medical-only, lost-time and litigated claims.
• Demonstrated working knowledge of workers’ compensation administration rules/laws.
• Good to excellent math and analytical ability.
• Good to excellent oral and written communication skills.
• Excellent customer service skills.

Education

• College degree or relevant experience.

Additional Company Details

The Company is an equal employment opportunity employer. We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. Base salary & Benefits include Health, dental, vision, life, disability, wellness, paid time off, 401(k) and profit-sharing plans. Salary Range: $55,000 - $65,000 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.