Workers Compensation Claims Specialist, Northeast Region
About The Position
The Workers Compensation Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to moderately complex claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with claimants, policyholders, appraisers, attorneys, and other third parties throughout the claim’s management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers. We are open to filling this position as an Associate Claims Specialist I (grade 10) or Claims Specialist I (grade 11), or Claims Specialist II (grade 12) depending on candidate experience. We prefer candidates from Connecticut, Maine, New Hampshire, Rhode Island, Vermont, New Jersey, New York, Pennsylvania, Massachusetts. If you do live within 50 miles of Westborough, MA or Weatogue, CT claims office, you will be required to go into the office twice per month. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. Training will require travel for 1 week to our office in Plano, TX in February.
Requirements
- Proven interpersonal, analytical and negotiation abilities required.
- Ability to provide information in a clear, concise manner, ability to build effective relationships.
- Bachelor`s degree or equivalent in addition to 1-year claims handling experience.
- Licensing may be required in some states.
Nice To Haves
- Knowledge of legal liability, insurance coverage and medical terminology preferred.
Responsibilities
- Manages an inventory of claims to evaluate compensability/liability.
- Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
- Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
- Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
- Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
- Performs other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
5,001-10,000 employees
