Workers Compensation Claims Representative

Auto-Owners Insurance•Appleton, WI

4d•$50,000 - $81,500•Hybrid

About The Position

Auto-Owners Insurance is seeking a Claims Representative to join its Workers Compensation Claims Branch. The representative investigates and adjusts workers’ compensation claims by gathering facts, determining policy coverage, evaluating losses and liability, and deciding whether to pay or deny claims. The role includes reviewing medical bills, authorizing and arranging timely, accurate payments, and conducting investigations by phone, mail, and on site. The representative obtains information from employers, employees, hospitals, doctors, and attorneys; works toward claim resolution; and may participate in arbitrations, mediations, depositions, or trials as needed. The role also serves agents, policyholders, and injured workers and develops familiarity with insurance coverage by reviewing policies, endorsements, and forms. The company offers a merit-based work-from-home program tied to job responsibilities. Initial training is in person; work-from-home flexibility afterward is determined by the leadership team. Compensation includes a base salary range of $50,000–$81,500, with starting salary determined by relevant experience, education, qualifications, and other job-related factors, plus several bonus opportunities.

Requirements

Bachelor’s degree or equivalent years of direct workers’ compensation claims handling experience for an insurance carrier.
Familiarity with a broad range of medical terminology.
Above-average written and verbal communication skills.
Ability to organize and interpret data, multitask, and make decisions independently.
Ability to resolve complex issues.
Interest in developing product knowledge through approved educational programs.
Ability to work in the U.S. without current or future sponsorship.

Responsibilities

Investigate claims and assemble facts, determine policy coverage, evaluate losses and legal liability, and pay or deny losses.
Review medical bills, authorize payments, and ensure payments are issued accurately and on time.
Conduct investigations by phone, mail, and on site.
Contact employers, employees, hospitals, doctors, and attorneys to obtain information needed to adjust claims.
Work toward claim resolution and attend arbitrations, mediations, depositions, or trials as necessary.
Serve the needs of agents, policyholders, and injured workers.
Review insurance policies, endorsements, and forms to become familiar with insurance coverage.