WC Sr. Claims Examiner

W. R. Berkley Corporation; Minneapolis (MN); Hybrid; USD 90,000 - 100,000; Full time

Benefits offered by this job

Competitive compensation

Robust benefits package

Health, dental, vision, life

401(k) and profit sharing

Job summary

W. R. Berkley Corporation's Berkley Risk unit in Minneapolis seeks an experienced workers’ compensation claims professional to manage a caseload of complex cases, including extended disability, litigation, and subrogation.

You will handle all technical aspects of claim management and ensure compliance with performance guidelines. You will investigate losses, set reserves, coordinate medical treatment, communicate with clients and counsel, and participate in reviews.

Qualifications

• Knowledge of workers’ compensation administration rules and laws.
• Excellent communication and presentation skills.
• Able to interface with clients, legal counsel, health care professionals.
• Strong math and analytical abilities.
• Excellent customer service skills.
• Basic PC skills and familiarity with Windows; experience with a client/server claims system.

Responsibilities

• Investigate claims and decide compensability for assigned files.
• Document handling activities and create action plans.
• Establish appropriate case reserves and manage medical treatment.
• Return injured workers to work and ensure compliance with guidelines.
• Identify loss trends and communicate with supervisor/clients.
• Use diary system to issue payments and manage claims.
• Manage subrogation and settlements; handle coverage B or conflicts.
• Address customer inquiries professionally.
• Participate in client claim reviews as scheduled.

Skills

Workers' compensation knowledge

Communication skills

Analytical ability

Customer service

Basic computer skills

Education

BA/BS degree with 3 years' experience; or 2 years post-high school with 5 years' experience in workers' compensation claims management

Tools

Windows

Client/server claims system

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

Responsible for managing a caseload consisting of incoming and more complex workers’ compensation cases including extended disability cases, litigation, employer’s liability claims, and assigned claims. Responsible for all technical aspects of claim management for assigned files including compliance with all established performance guidelines.

• Investigate claims and make appropriate decisions regarding claim compensability and general claims management for assigned files.
• Document claim handling activities; create and document action plans.
• Establish appropriate case reserves.
• Actively manage medical treatment and disability while assisting the injured worker to return to work.
• Comply with all performance guidelines.
• Identify loss trends and communicate to supervisor and/or clients.
• Use automated diary system to issue indemnity payments and for claims management.
• Investigate and manage claim subrogation and negotiate settlements.
• Manage coverage B or conflict of interest cases as assigned.
• Address customer complaints and inquiries in an exemplary and professional manner.
• Participate in client claim reviews when scheduled or requested.
• May perform other functions as assigned.

Qualifications

• Demonstrated working knowledge of workers’ compensation administration rules/laws.
• Excellent communication and presentation skills.
• Must be able to interface with clients, legal counsel, health care professionals, etc.
• Good math and analytical ability.
• Excellent customer service skills.
• Basic PC skills and a working knowledge of Windows environment. Experience with a client/server based claims processing system.

Education

• BA/BS degree with three years’ experience. Experience must include litigation, subrogation and complex medical/legal issues; or two years post-high school education and five years’ experience in workers compensation claims management.

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: $$90,000 - $100,000 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.

Additional Requirements

• Travel: Occasional travel.