WC Sr. Claims Examiner - Temp

Berkley•Saint Paul, MN

About The Position

The WC Sr. Claims Examiner manages a caseload of incoming and complex workers’ compensation claims, including extended disability, litigation, employer’s liability, and assigned claims. The role is responsible for all technical aspects of claim management for assigned files and for meeting established performance guidelines. The examiner investigates claims, determines compensability and appropriate claim handling, documents activities and action plans, establishes reserves, and manages medical treatment and disability while supporting injured workers’ return to work. The position also involves managing subrogation and settlements, handling coverage B or conflict-of-interest cases as assigned, responding professionally to customer inquiries and complaints, and participating in client claim reviews. Berkley Risk provides program administration services and insurance operations for self-insured entities, with options that can include taking or sharing risk or providing a purely administrative solution. This position is temporary. The stated pay rate is $60 per hour; actual compensation is determined by factors including role scope, complexity, location, and candidate qualifications.

Requirements

Demonstrated working knowledge of workers’ compensation administration rules and laws.
Excellent communication and presentation skills.
Ability to interface with clients, legal counsel, and health care professionals.
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 workers’ compensation claims-management experience.

Responsibilities

Manage a caseload of incoming and complex workers’ compensation cases, including extended disability, litigation, employer’s liability, and assigned claims.
Manage all technical aspects of assigned claims in compliance with established performance guidelines.
Investigate claims and make appropriate compensability and claim-management decisions.
Document claim-handling activities and create and document action plans.
Establish appropriate case reserves.
Manage medical treatment and disability and assist injured workers in returning to work.
Identify loss trends and communicate them to a supervisor and/or clients.
Use the automated diary system to issue indemnity payments and manage claims.
Investigate and manage claim 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.