Senior Claims Specialist

BerkleyHomewood, AL
2d

About The Position

This position is responsible for managing both lost time and med only claims across multiple jurisdictions up to $250,000 in exposure. This includes investigation, evaluation, and resolution of claims. Interface with underwriting, risk management, case management, clients, and vendors as appropriate in controlling costs and loss ratios and providing the claimant with appropriate care. Provide leadership within the claims department.

Requirements

  • Bachelor’s degree with concentration in criminal justice, public administration, business, nursing or insurance OR equivalent work experience.
  • Five (5) years’ minimum of experience adjusting workers’ compensation claims with significant experience handling Workers’ Compensation claims.
  • Possess and maintain a professional adjusting license in all jurisdictions applicable or obtained within one year of job acceptance.
  • Strong interpersonal, analytical, and negotiation skills.

Nice To Haves

  • Experience across multiple jurisdictions preferred.
  • Ten (10) years’ experience preferred.

Responsibilities

  • Oversee catastrophic and large loss claims from beginning to resolution.
  • Manage all technical aspects of claims including coverage, disability benefit management, medical management, file management, litigation management, subrogation, reserving and settlement.
  • Verify and interpret coverage issues.
  • Consult with attorneys, assist in negotiation of settlement, mediations and trials (attend trials as necessary).
  • Resolve problems involving multi-faceted claims handling.
  • Investigate, evaluate, and negotiate claims toward resolution and provide medical needs within jurisdictional guidelines and Berkley Industrial Comp philosophies.
  • Determinate appropriate reserves to adequately reflect exposure of losses.
  • Attend and participate in training sessions to the accounts or account visits and claim reviews.

Benefits

  • The company offers a competitive compensation plan and robust benefits package for full time regular employees
  • The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
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