Senior Claims Representative – California Workers Compensation

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⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $75k - $110k / year

⏰ Full Time

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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W. R. Berkley Corporation

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1967

🛡️ Insurance

💸 Finance

🤝 B2B

Insurance • Finance • B2B

W. R. Berkley Corporation is a leading insurance company that operates through over 55 businesses, providing a wide range of insurance solutions for both commercial and high-net-worth individual clients. With deep expertise in various industries, Berkley specializes in offering tailored insurance products that cater to niche markets. The company emphasizes strong partnerships with agents and brokers to deliver coverage for unique risks and emerging needs, ensuring comprehensive protection for its customers.

📋 Description

• Investigate, evaluate, mitigate, and resolve an inventory of lost time and catastrophic workers’ compensation injury claims in multiple jurisdictions • Interview injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due • Calculate and set timely financial reserves and proactively manage reserve adequacy throughout the claim lifecycle • Record and code injured worker demographics, job information, and accident information in the claims management system • File necessary forms with state regulatory agencies • Issue timely payments to injured workers, medical providers, and service vendors • Coordinate and actively manage medical treatment to ensure timely rehabilitation • Negotiate settlements within designated authority with injured workers and attorneys • Serve as subject matter expert on the Workers’ Compensation Act, adjudication process, and regulatory compliance framework • Identify and manage subrogation, Second Injury Fund, and joint coverage recovery opportunities • Communicate claim activity and status updates to policyholders, injured workers, and other interested parties • Notify management and develop reports for large exposure claims and comply with reinsurance reporting requirements • Manage the claims litigation process for timely and cost-effective resolution • Monitor managed care and investigation vendor expenses and effectiveness • Travel periodically to hearings, conferences, and training sessions • Attend and participate in claim file reviews with management and defense attorneys • Coordinate and lead special projects or processes as assigned • Assist with oversight and supervisory duties when the team supervisor is unavailable or as assigned • Support training, staff development, and vendor management activities • Continuously improve product and business results through innovation

🎯 Requirements

• 3 - 5 years of experience handling workers’ compensation claims • 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 • Bachelors’ degree or equivalent insurance industry work experience • AIC, ARM, CCP, or CPCU insurance designation preferred • Obtain and maintain adjuster license(s) in assigned jurisdictions

🏖️ Benefits

• Health insurance • Dental insurance • Vision insurance • Life insurance • Disability insurance • Wellness benefits • Paid time off • 401(k) plan • Profit-sharing plan • Competitive compensation plan • Robust benefits package