Senior Claims Representative - Workers' Compensation

Penn National Insurance•Harrisburg, PA

12h•Hybrid

About The Position

The Senior Claims Representative investigates, evaluates, and disposes of assigned workers’ compensation claims in a timely manner, seeking appropriate settlements within applicable legal statutes, policy provisions, and company or client guidelines. The position develops claims files from initial assignment through disposition, documents actions accurately, and handles claims that may involve complex coverage and liability issues. The role may require attendance at civil proceedings or workers’ compensation hearings and may include participation in, or supervision of, a Claims Catastrophe Team. The position works with the Team Leader, Manager, Home Office, and a range of internal and external contacts to develop case strategy, advance investigations, and resolve claims. Candidates may live in approved hiring markets if they can report on a hybrid basis to the Harrisburg, Pennsylvania; Pittsburgh, Pennsylvania; or Waukesha, Wisconsin office. Overnight travel is required.

Requirements

At least 5 years of experience in workers’ compensation claims handling.
Good understanding of tort and state laws applicable to assigned claims, the Unfair Claims Settlement Act, and insurance policy coverages and provisions.
Good understanding of terminology applicable to assigned claims, including medical, legal, automotive, and construction terminology.
Good oral and written communication skills.
Good interpersonal, negotiation, customer service, analysis, evaluation, and decision-making skills.
Strong sense of urgency.
Good PC skills, with an emphasis on Microsoft Office products.
Good planning and organization skills.
Ability to work independently and as a member of a team.
Adjuster’s license, or willingness to obtain one as required.
Valid driver’s license and ability to operate a motor vehicle.
Ability to travel, including overnight stays.
Ability to maintain acceptable attendance and adhere to scheduled work hours.
Ability to use a computer and office equipment, accurately access and enter information in automated systems, communicate by telephone or monitoring devices, present information to individuals and groups, and interpret and apply concepts that may not be based on established guidelines.

Nice To Haves

Continuing education in insurance-related courses, such as IIA Certificate in General Insurance, Senior Claims Law Associate, Associate in Claims, and/or Workers’ Compensation courses (PA 10, 11, 12, and 13).
Associate’s degree in Claims and/or Senior Claims Law Associate designation.

Responsibilities

Investigate, evaluate, and dispose of assigned claims in a timely manner and achieve best-practices settlements within legal statutes, policy provisions, and company or client guidelines.
Develop claims files from initial assignment through disposition.
Prepare accurate and complete claim-file documentation to justify actions and provide an effective audit trail.
Identify and pursue subrogation, contribution, and salvage opportunities when available to reduce or recover payments.
Complete timely actions, including verifying coverage, setting or adjusting reserves, and making appropriate contacts.
Collaborate with the Team Leader, Manager, and Home Office as necessary to develop case strategy, advance investigations, and dispose of claims.
Communicate tactfully and completely to support negotiations, build rapport, and project a positive corporate and personal image.
Handle claims involving complex coverage and liability issues, including attending civil proceedings or workers’ compensation hearings when required.
Participate as a member of a Claims Catastrophe Team and may act as its supervisor.
Pursue self-development and training to maintain, improve, or acquire claims-handling skills.
Perform other duties as assigned by the reporting managers.