Claims Specialist/Senior Claims Specialist-Workers Compensation bei Gaig

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow.

At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.

Alternative Markets specialize in primary programs on either a traditional guaranteed cost (Specialty Programs) or risk-sharing basis (Agency, Association or Group Captives). Alternative Markets focuses on niche programs.

https://www.greatamericaninsurancegroup.com/about-us/business-operations/division/alternative-markets

Our Alternative Markets Division is looking for a Claims Specialist/Senior Claims Specialist. The ideal candidate would be available to work a hybrid schedule out of our Cincinnati, OH or Windsor, CT office. Job title and salary will be dependent upon successful applicant’s level of experience.

Essential Job Functions and Responsibilities

• Manages an inventory of medical only and lost time claims.
• Plans and conducts claim investigations to confirm coverage and to determine liability, compensability and damages.
• Analyzes and negotiates appropriate claim settlements/reserves within prescribed authority. May attend arbitrations, mediations, depositions, or trials.
• Conveys information regarding coverage and settlements to insureds, claimants, and external partners.
• Authorizes payments in accordance with assigned authority limits and ensures payments are made in a timely manner.
• Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.
• Responsible for compliance with all state reporting requirements.
• Follows all necessary medical treatment guidelines, including but not limited to utilization of vendors to ensure proper treatment and care.
• Performs other duties as assigned.

Job Requirements

• Education: Bachelor’s Degree recommended but not required. Equivalent experience in Risk Management and Insurance, or a related field preferred. Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC), CPCU but this is not required.
• Experience: Generally, 5+ years of experience in worker’s compensation claims handling. Active adjuster licensing is needed. California claim handling preferred but not a requirement.
• Scope of Job/Qualifications: Works within broad limits and authority on assignments of variety of claims. Demonstrates excellent analytical, communication, negotiation, and problem-solving skills. Maintains strong knowledge of insurance policies, coverage, and claims handling procedures. Maintains knowledge of industry laws and regulations. Advanced ability to organize and prioritize caseloads, ensuring timely resolution of claims.  Excellent interpersonal and communication skills with the ability to build relationships and lead negotiations. Proven ability to handle confidential information with discretion.

Business Unit:

Benefits:

Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs.

We offer a competitive Total Rewards package, including medical, dental, and vision plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees.

Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process.