Senior Claims Analyst

Crum & Forster • Brookfield, WI

8d • $36,000 - $67,800 • Remote

About The Position

The Senior Claims Analyst is responsible for the handling of medical only Workers Compensation claims to ensure timely and accurate processing and superior customer service. The Senior Analyst is accountable for the accurate determination of the proper amount due the insured or claimant within assigned authority limits and for the compliance with company policies and procedures. Strong preference for the candidate to be based in the Milwaukee, WI area but open to remote anywhere.

Requirements

• High school diploma and 6+ years of relevant experience required
• Excellent written and verbal communication skills.
• General knowledge of insurance and/or claims is a plus.
• Strong working knowledge of the Microsoft Office suite of programs and an aptitude to learn new programs.

Nice To Haves

• College degree is preferred but may be waived based on prior claim or business experience.

Responsibilities

• Verify, identify coverage, compensability issues and conduct limited investigations.
• Identify subrogation, second injury fund and fraud situations and develop information to pursue.
• Conduct timely initial and ongoing contacts and investigation based on best practices guidelines.
• Maintain proper file on all activities and issues.
• Obtain medical records relating to the claim.
• Review claim for necessity and relatedness.
• Provide case management to files with ongoing treatment using authorized outside resources where needed.
• Prepare and submit appropriate state and agency forms timely.
• Assist with account coordination and claims reviews.
• Timely process bills and other benefit payments.
• Work closely and communicate regularly with Underwriting, Risk Engineering, and Account Executives.
• Address questions, concerns and issues from outside parties: insured’s, agents, state agencies, injured employees, attorneys.
• Provide superior customer service to agents, insured’s and others during the claims handling process.
• When appropriate and necessary, consults with manager or director of claims to obtain authority for activities and settlements that exceed assigned authority.
• Document all significant activities and contacts in the claims file, in accordance with established best practices, company claims handling procedures and applicable state regulations.
• Assist with account coordination and claims reviews.
• Timely process bills and other benefit payments.
• Obtain non-resident adjuster licenses for mandatory states.
• Take continuing education courses to maintain license.

Benefits

• Competitive compensation package
• Generous 401K employer match
• Employee Stock Purchase plan with employer matching
• Generous Paid Time Off
• Excellent benefits that go beyond health, dental & vision. Our programs are focused on your whole family’s wellness, including your physical, mental and financial wellbeing
• A core C&F tenet is owning your career development, so we provide a wealth of ways for you to keep learning, including tuition reimbursement, industry-related certifications and professional training to keep you progressing on your chosen path
• A dynamic, ambitious, fun and exciting work environment
• We believe you do well by doing good and want to encourage a spirit of social and community responsibility, matching donation program, volunteer opportunities, and an employee-driven corporate giving program that lets you participate and support your community
• At C&F you will BELONG

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED