Workers' Compensation Claim Specialist

Amerisure Insurance; Lawrenceville (GA); Hybrid; USD 70,000 - 100,000; Full time

Job summary

Amerisure Mutual Insurance Company seeks a Workers’ Compensation Claims Specialist to support a two-day hybrid work model in one of our offices. You will provide quality investigation and analysis on high-complexity claims, adjust cases, and coordinate with agents, policyholders and employees to reach proper resolutions.

The ideal candidate has a bachelor’s degree, 6 years of experience in workers’ compensation indemnity claims, and a designation such as AIC/SLCA, with strong analytical and

Qualifications

• Bachelor’s degree or equivalent combination of education.
• 6 years of experience handling workers’ compensation indemnity claims of high level of complexity/severity.
• AIC or SLCA certification preferred.
• Ability to obtain appropriate state licensing as required.
• Proficient computer skills including Microsoft Office Suite.
• Demonstrated ability to build positive relationships within department and with external customers.
• Strong analytical skills and attention to detail.
• Excellent verbal and written communication skills with internal and external customers.
• Ability to travel overnight up to 10%.
• Ability to travel daily between locations.

Responsibilities

• Collaborate with agents, policyholders and internal stakeholders on high complexity/severity claims.
• Investigate losses, identify coverage, determine compensability, review documents and pleadings.
• Collaborate with counsel to manage litigated claims and analyze documents.
• Develop action plans to conclude claims and settle within guidelines.
• Establish and maintain reserves reflecting financial exposure.
• Identify external resources as needed and control costs.
• Review and interpret commercial policies and communicate coverage issues.
• Participate on cross-functional teams to resolve issues and implement preventive solutions.

Skills

Analytical skills

Verbal and written communication

Relationship building

Attention to detail

Travel readiness

Education

Bachelor’s degree or equivalent

AIC or SLCA certification

State licensing capability

Tools

Microsoft Office Suite

Job description

Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure’s promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best “A” (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Workers’ Compensation Claims Specialist that can do a 2-day hybrid approach in one of our offices. The ideal candidate will possess the following skill set.

Summary Statement

Provides quality investigation and analysis to adjust claims of high complexity/severity, including litigated files, to proper resolution. Promotes the success of the organization through development of relationships with agencies, policyholders and employees. Serves as a relationship contact for assigned agent(s) related to all claims.

Essential Tasks/Major Duties

• Collaborate proactively with agents, policyholders and internal stakeholders on claims of high complexity/severity and provide strategic input on book of business.
• Investigate losses, identify coverage, determine compensability, review and analyze documents and legal pleadings independently.
• Collaborate with counsel to manage litigated claims and leverage past experience to analyze documents and legal pleadings.
• Develop plan of action to proactively conclude claims, timely evaluate damages, engage other parties in negotiations and settle claims pursuant to guidelines.
• Establish and maintain proper reserves for each claim to accurately reflect the financial exposure.
• Determine need for, identify and engage external resources as needed to execute proper resolutions while monitoring and controlling costs.
• Review and interpret commercial insurance policies and accordingly communicate coverage issues verbally and in writing.
• Participate on cross functional teams to identify and resolve issues and design and implement solutions to prevent future occurrence as necessary.

Knowledge, Skills & Abilities

• Bachelor’s degree or equivalent combination of education.
• 6 years of experience handling workers’ compensation indemnity claims of high level of complexity/severity.
• AIC or SLCA certification preferred.
• Ability to obtain appropriate state licensing as required.
• Proficient computer skills required including Microsoft Office Suite.
• Demonstrated successful ability to build positive relationships and partnerships within department, across the organization and with external customers.
• Strong analytical skills and attention to detail.
• Excellent verbal and written communication skills with the ability to interact with internal and external customers.
• Ability to travel overnight up to 10%
• Ability to travel daily between locations.

Just as we are committed to creating exceptional value for our Partners For Success® agencies and policyholders, Amerisure also remains committed to being an employer of choice.

We reinforce this commitment by adhering to an Employee Value Proposition that, in part, is provided through a competitive total rewards package. This package includes competitive base pay, performance-based incentive pay, comprehensive health and welfare benefits, a 401(k) savings plan with profit sharing, and generous paid time off programs. We also offer flexible work arrangements to promote work-life balance. Recognized as one of the Best and Brightest® Companies to Work For in the Nation and one of Business Insurance magazine’s Best Places to Work in Insurance, we provide a workplace that fosters excellence and professional growth. If you are looking for a collaborative and rewarding career, Amerisure is looking for you.

Amerisure Mutual Insurance Company is an Equal Employment Opportunity employer. Amerisure provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (to include sexual orientation and gender identity), national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable federal, state, or local laws. Amerisure complies with all applicable laws governing nondiscrimination in employment in all locations where the company operates. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Amerisure prohibits harassment or discrimination of any kind and is committed to maintaining a workplace free from unlawful harassment or discrimination. Amerisure prohibits retaliation against anyone who reports discrimination, participates in an investigation, or opposes unlawful practices. Any improper interference with an employee’s ability to perform their job duties may result in disciplinary action, up to and including termination.