Claims Representative II

Berkley•Towson, MD

42d•$70,000 - $85,000•Remote

About The Position

With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results. All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P. For further information about Key Risk please visit www.KeyRisk.com

Requirements

3+ years of MD and DC workers compensation claims handling experience preferred
In depth knowledge of appropriate insurance principles and laws of workers’ compensation, preferably jurisdiction specific.
May be required to obtain Adjuster license for other jurisdictions
Strong written and verbal communication skills.
Strong interpersonal, time management and organizational skills.
Strong negotiation skills.
Proven critical thinking skills that demonstrates 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 though 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.