Workers Compensation Claims Representative

aoins; Appleton (WI); Hybrid; USD 50,000 - 82,000; Full time

Benefits offered by this job

Matched 401(k)

Pension plan

Health insurance (medical, dental, and

Vision insurance

Life insurance

Short-term disability

Long-term disability

FSA - health care

FSA - dependent care

Paid time off

Adoption assistance

Education matching

Gym reimbursement

Job summary

Auto-Owners Insurance seeks a motivated Claims Representative for its Workers’ Compensation Claims Branch. The role starts with in-person training, then offers merit-based work-from-home flexibility defined by leadership.

Responsibilities include investigating claims, reviewing medical bills, and coordinating with employers, hospitals, and attorneys to resolve claims and ensure timely payments. The candidate should have a Bachelor's degree or comparable workers' compensation experience, strong

Qualifications

• Bachelor's degree or equivalent years of direct workers' compensation claims handling experience for an insurance carrier.
• Familiarity with a broad range of medical terminology.
• Above average communication skills (written and verbal).
• Ability to organize and interpret data, multi-task, and make decisions independently.
• Ability to resolve complex issues.
• An interest in developing product knowledge through participation in approved educational programs.

Responsibilities

• Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses.
• Review medical bills, authorize payments and ensure payments are issued in a timely and accurate manner.
• Handle investigations by phone, mail and on-site investigations.
• Contact employers, employees, hospitals, doctors and attorneys to secure information to properly adjust the claim.
• Work toward the resolution of claims, and may attend arbitrations, mediations, depositions, or trials as necessary.
• Service the needs of agents, policyholders and injured workers.
• Become familiar with insurance coverage by reviewing policies, endorsements and forms.

Skills

Medical terminology

Communication skills

Data organization

Independent decisions

Complex issue resolution

Product knowledge

Education

Bachelor's degree or equivalent workers' comp claims experience

Job description

Job Description

We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team.

Auto-Owners Insurance, a top-rated Insurance Carrier, is seeking a motivated candidate to join our team as a Claims Representative in our Workers Compensation Claims Branch. The position requires the following but is not limited to:

• Investigate and assemble facts, determine policy coverage, evaluate the amount of loss, analyze legal liability and pay or deny losses.
• Review medical bills, authorize payments and ensure payments are issued in a timely and accurate manner.
• Handle investigations by phone, mail and on-site investigations.
• Contact employers, employees, hospitals, doctors and attorneys to secure information to properly adjust the claim.
• Work toward the resolution of claims, and may attend arbitrations, mediations, depositions, or trials as necessary.
• Service the needs of agents, policyholders and injured workers.
• Become familiar with insurance coverage by reviewing insurance policies, endorsements and forms.

Desired Skills & Experience

• Bachelor's degree or equivalent years of direct workers compensation claims handling experience for an insurance carrier.
• Familiarity with a broad range of medical terminology.
• Above average communication skills (written and verbal).
• Ability to organize and interpret data, multi-task, and make decisions independently.
• Ability to resolve complex issues.
• An interest in developing product knowledge through participation in approved educational programs.

Compensation

Auto-Owners offers a generous compensation package. The base salary range for this position is $50,000-$81,500. Starting salary within the range is determined based on relevant experience, education, qualifications, and other job-related factors. Other components of the compensation package include several bonus opportunities.

Benefits

• matched 401(k)
• fully funded pension plan (once vested)
• medical, prescription, dental and vision insurance
• associate, spouse and child life insurance
• short-term disability
• long-term disability
• health care flexible spending accounts
• dependent care flexible spending accounts
• generous paid time off including holidays, vacation days, personal time, sick leave and parental leave
• adoption assistance
• discounts on personal insurance
• education matching gift program
• gym membership and fitness class reimbursement program

Equal Employment Opportunity

Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law.

*Please note that the ability to work in the U.S. without current or future sponsorship is a requirement.