Claims Representative II

Berkley • High Point, NC

71d

About The Position

Key Risk is looking for a claims professional who enjoys analysis and management of workers compensation claims. The position involves analyzing and processing workers’ compensation claims by investigating and gathering information to determine the exposure on the claim. The claims professional will negotiate settlement of claims up to designated authority level and make claims payments. They will also calculate and assign timely appropriate reserves to claims and continue to manage reserve adequacy throughout the life of the claim. The role requires developing and managing claims through well-developed action plans and ensuring timely and cost-effective claims resolution. Additionally, the claims professional will prepare necessary state filings within statutory limits, actively manage the litigation process, and coordinate vendor referrals for additional investigation and/or litigation management. The position demands frequent communication with all appropriate parties involved with the claim and maintaining professional client relationships.

Requirements

• BA/BS Degree
• 2-3 years of workers compensation claims experience
• Adjuster license strongly desired or ability to obtain license within six months
• Knowledge of appropriate insurance principles and laws of workers’ compensation, preferably jurisdiction specific.
• Strong verbal and written communication skills.
• Strong interpersonal, time management and organizational skills.
• Strong negotiation skills.
• Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to detail.
• Ability to perform with a sense of urgency.
• Ability to work both independently and within a team environment.
• Ability to travel for business purposes, approximately less than 10%.

Responsibilities

• Analyzes and processes workers’ compensation claims by investigating and gathering information to determine the exposure on the claim.
• Negotiate settlement of claims up to designated authority level and makes claims payments.
• Calculates and assigns timely an appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level.
• Develops and manages claims through well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
• Prepares necessary state filings within statutory limits.
• Actively manages the litigation process; ensures timely and cost-effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
• Frequently communicates with all appropriate parties involved with the claim.
• Maintains professional client relationships.
• Actively executes appropriate claims activities to ensure consistent delivery of quality claims services.

Benefits

• Competitive compensation plan
• Robust benefits package for full time regular employees

What This Job Offers

• Job Type: Full-time
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees