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Claims Representative at Berkley

Berkley · Manassas, United States Of America · Onsite

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Company Details:

Berkley_Net_Logo

BerkleyNet is an innovative workers compensation insurance provider that does all our business online. Our Goal? To make doing business “Ridiculously Fast. Amazingly Easy.”

 

Responsibilities:

As a Claims Representative, you will be responsible for the investigation, evaluation, mitigation and resolution of medical only and lost time workers’ compensation claims of moderate complexity in multiple jurisdictions.

  • Investigate workers’ compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due
  • Calculate and set timely financial reserves and proactively manages reserve adequacy throughout claim lifecycle
  • Record and code injured worker demographics, job information and accident information in company’s claims management system and files necessary forms with state regulatory agencies
  • Issue timely payments to injured workers, medical providers and service vendors
  • Coordinate and actively manage medical treatment of injured workers to ensure timely rehabilitation
  • Negotiate settlements of claims within designated authority with injured workers and attorneys
  • Demonstrate a working knowledge of the Workers’ Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions
  • Identify and manage subrogation, Second Injury Fund and joint coverage recovery opportunities
  • Regularly communicate claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful manner
  • Respond in a timely manner to communications from policyholders, injured workers, and other interested parties
  • Notify management and develops reports for large exposure claims and complies with reinsurance reporting requirements
  • Manage the claims litigation process to ensure timely and cost-effective claims resolution
  • Monitor the expenses and effectiveness of managed care and investigation vendors
  • Actively participate in special projects as assigned by management
  • Periodically travel to attend hearings, conferences and training sessions
  • Attend and participates in claim file reviews with management and defense attorneys
  • Continuously strives to improve our product and business results through innovation
  • Obtain and maintain adjuster licenses in assigned jurisdictions where required
Qualifications:
  • Excellent written and verbal communication skills
  • Strong interpersonal and relationship building skills
  • Exceptional time management and organization skills
  • Strong analytical and critical thinking skills
  • Ability to work independently and strategically problem solve
  • Ability to diplomatically manage conflict
  • Ability to develop relationships within the organization and work effectively across departments
  • Strong discretion and integrity in dealing with highly confidential and sensitive information
  • Detail oriented

Education 

  • Bachelors’ degree or equivalent insurance industry work experience
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.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:•Low level of domestic U.S. travel required (up to 5% - 10% of time)Sponsorship Details:Sponsorship not Offered for this Role
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