Claims Specialist (Workers Compensation)

Society Insurance Company • Fond du Lac, WI

20h • Hybrid

About The Position

Society Insurance is seeking an entry-level Claims Specialist to join our Workers’ Compensation team. With manager guidance and structured training, the Claims Specialist will learn to investigate and resolve mild to moderate complex claims that may have limited period of indemnity; and will monitor ongoing permanency/death claims in accordance to claims handling practices.

Requirements

• Bachelor’s Degree in business or related field OR 1+ years of claims handling experience involving the exercise of discretionary decision-making as determined by Society Insurance OR 3+ years of knowledge in the property & casualty insurance industry
• Familiarity with PC applications including word processing, Internet, spreadsheets, and e-mail software.
• Ability to obtain and maintain proper licensing prior to handling a state that requires it.
• Valid driver’s license and a satisfactory driving record as determined by Society Insurance.

Nice To Haves

• Prior workers’ compensation indemnity experience highly desirable.
• Professional insurance designations highly desirable.

Responsibilities

• Handles and settles mild to moderate complex claims that may have limited period of indemnity; monitors ongoing permanency/death claims; reaching agreement with claimant according to policy provisions and authority level; and handling subrogation within authority level.
• Resolves questionable claims by investigating and comparing claims information with evidence.
• Identifies files involving potential investigation with manager guidance by analyzing documentation and records, evaluating evidence, and referring files to appropriate staff.
• Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; reviewing police and hospital records; and consulting with experts.
• Promotes early return to work by communicating and coordinating between involved parties.
• Keeps current with claims through follow-up discussions with injured workers and insureds; and makes recommendations regarding future handling of files based on claim facts.
• Ensures accurate file documentation by complying with claims handling guidelines and state requirements.
• Ensures company guidelines and procedures are followed by overseeing independent adjusters during investigations and attorneys in the handling of discovery and settlement.
• Develops and maintains professional, technical knowledge and expertise in a specified line(s) of business through training courses and continuing education coursework.
• Contributes to team effort by participating in determining department investigation guidelines; providing feedback to underwriting as needed.

Benefits

• Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance
• Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan
• Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options
• Education: Career Coaching; company-paid courses; student loan and tuition reimbursement
• Community: Charitable Match; paid volunteer time; team sponsorships
• Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 101-250 employees