WC Sr. Claims Examiner - Temp

Berkley•Saint Paul, MN

About The Position

Berkley Risk, a member company of W. R. Berkley Corporation, provides program administration services and insurance operations for self-insured entities. The Senior Claims Examiner manages a caseload of incoming and complex workers’ compensation claims, including extended disability, litigation, employer’s liability, and assigned claims. The role handles all technical aspects of assigned files while complying with established performance guidelines, investigating claims, deciding compensability, and managing claims through resolution.

Requirements

Demonstrated working knowledge of workers’ compensation administration rules and laws.
Excellent communication and presentation skills.
Ability to interface with clients, legal counsel, health care professionals, and others.
Good math and analytical ability.
Excellent customer service skills.
Basic PC skills and working knowledge of the Windows environment.
Experience with a client/server-based claims processing system.
Either a BA/BS degree and three years of experience, including litigation, subrogation, and complex medical/legal issues; or two years of post-high-school education and five years of experience in workers’ compensation claims management.

Responsibilities

Manage a caseload of incoming and complex workers’ compensation claims, including extended disability, litigation, employer’s liability, and assigned claims.
Handle all technical aspects of assigned claims and comply with established performance guidelines.
Investigate claims and make decisions about compensability and general claims management.
Document claim activities and create and maintain action plans.
Establish appropriate case reserves.
Manage medical treatment and disability and assist injured workers with returning to work.
Identify loss trends and communicate them to supervisors and/or clients.
Use the automated diary system to issue indemnity payments and manage claims.
Investigate and manage subrogation and negotiate settlements.
Manage coverage B or conflict-of-interest cases as assigned.
Address customer complaints and inquiries professionally.
Participate in client claim reviews when scheduled or requested.
Perform other functions as assigned.