WC Claims Examiner

Berkley; St. Paul (AK); On-site; USD 55,000 - 65,000; Full time

Benefits offered by this job

Health, dental, vision

Life and disability insurance

401(k) with profit sharing

Paid time off

Job summary

Berkley is seeking a workers’ compensation claims professional in Alaska to adjudicate and investigate assigned files, focusing on timely reserves, return-to-work discussions, and cost containment. You will interact with employers, state agencies, and providers to manage complex claims and ensure compliance.

The role requires 1–2 years of experience, strong math skills, and excellent communication. A college degree or relevant experience is acceptable, with a robust benefits package offered.

Qualifications

• 1–2 years of workers’ compensation claim processing experience.
• Experience with medical-only, lost-time and litigated claims.
• Knowledge of workers’ compensation rules and laws.
• Strong math and analytical ability.
• Excellent oral and written communication and customer service.

Responsibilities

• Investigate and adjudicate workers’ compensation claims including lost time and litigation.
• 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 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.
• Interact with clients to establish/improve communication and service capabilities.
• Interact with state agencies, attorneys and other providers.
• Address customer complaints and inquiries professionally.
• Achieve performance outcomes related to quality and quantity of work.
• Provide cost containment for individual claim and overall costs.

Skills

Math & analytical ability

Oral and written communication

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.