Claims Examiner III

Markel • Cranston, RI

2d • $82,500 - $171,450 • Onsite

About The Position

This position will be responsible for the resolution of high complexity and high exposure Workers Compensation claims in multiple jurisdictions. The position will have increased responsibility for decision making within their authority and work under general direction from their manager.

Requirements

• Bachelor's degree in a business-related field preferred; equivalent insurance industry experience may be substituted.
• Excellent written and verbal communication skills.
• Strong analytical, problem-solving, organizational, and time management skills.
• Ability to deliver outstanding customer service and work effectively in a team environment.
• Intermediate proficiency in Microsoft Office applications, including Excel, Outlook, PowerPoint, and Word.
• Ability to analyze complex coverage, liability, compensability, and medical management issues and make sound claim decisions.
• Strong negotiation and decision-making skills.
• US Work Authorization required. Markel does not provide visa sponsorship for this position, now or in the future.

Nice To Haves

• Insurance designation(s) preferred.
• Strong understanding of medical terminology preferred.
• Demonstrated commitment to continuous improvement and professional development.

Responsibilities

• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Analyzes coverage and communicates coverage positions
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Directs and monitors assignments to experts and outside counsel
• Evaluates information on coverage, compensability, and medical management to determine the extent of insured's exposure
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Focus on driving claims to a resolution with a focus of returning the injured back to work
• Evaluate, Negotiate and settle claim when appropriate
• Prepares reports by collecting and summarizing information
• Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives
• Participates in special projects or assists other team members as requested
• Attend all state specific trainings as scheduled
• Travel to mediations, trials, and conferences as required

Benefits

• competitive benefit programs
• multiple health, dental and vision insurance plan options
• optional life, disability, and AD&D insurance
• 401(k) with employer match contributions
• Employee Stock Purchase Plan
• PTO
• corporate holidays
• floating holidays
• parental leave

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level