WC Sr. Claims Examiner

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.

About Berkley

Company Details We're a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company.

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.

Requirements

• Demonstrated working knowledge of workers' compensation administration rules/laws.
• 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.
• Customer Focus and Teamwork Flexibility Delivers Results Technical & Job Excellence Accountability 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.

Preferred

• Experience with a client/server based claims processing system.

Pay

$80,000 - $110,000 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.

Benefits

• The company offers a competitive compensation plan and robust benefits package for full time regular employees.
• & Benefits include Health, dental, vision, life, disability, wellness, paid time off, 401(k) and profit-sharing plans.

Travel

Occasional travel. While performing the duties of this job, the employee is regularly required to be seated for sustained periods of time; be able to pick up, pinch, twist, or keyboard; must be able to communicate detailed or important information accurately; distinguish sounds at normal levels (with or without correction) and be able to receive detailed information orally. The employee is occasionally required to move about the office to accomplish tasks; ability to reach in any direction; raise or lower objects or move objects from place to place; and hold onto objects. Occasionally, the employee may need to move or exert force up to 10 pounds. The employee is regularly required to operate a computer and other office equipment (phone, copier and printer) Excellent communication and presentation skills.

Communication

Additional Company Details Important Outside Agency Notice: Only solicited resumes/candidate profiles that are submitted by a Berkley Preferred Agency Partner that have been requested by Berkley Internal Recruiting to engage in a particular search will be subject to the payment of Agency fees as defined in the formal agency agreement. Any unsolicited resumes/candidate profiles are not subject to payment of the agency fees.