Workers Compensation Claims Specialist

CNA • Downers Grove, IL

2d • Hybrid

About The Position

This individual-contributor position works under moderate direction and within defined authority limits to manage commercial workers’ compensation claims with moderate to high complexity and exposure. The specialist investigates and resolves claims in accordance with company protocols, quality standards, and customer-service expectations. The role involves regular communication with customers and insureds and may be dedicated to specific accounts.

Requirements

• Bachelor’s degree or equivalent experience.
• Typically at least four years of relevant experience, preferably in claim handling.
• Candidates who have successfully completed the CNA Claim Training Program may be considered with two years of claim-handling experience.
• Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.
• Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
• Strong verbal and written communication skills, including the ability to build positive working relationships and present information to customers, claimants, and senior management.
• Ability to develop collaborative relationships with internal and external work partners.
• Ability to exercise independent judgment, solve moderately complex problems, and make sound business decisions.
• Investigative experience, an analytical mindset, and critical-thinking skills.
• Strong work ethic, time-management skills, and organizational skills.
• Ability to manage multiple priorities in a fast-paced, collaborative environment while maintaining high productivity.
• Ability to negotiate low- to moderately complex settlements.
• Adaptability in a changing environment.
• Knowledge of Microsoft Office Suite and ability to learn business-related software.
• Ability to value diverse opinions and ideas.

Nice To Haves

• Professional designations are a plus, such as CPCU.

Responsibilities

• Manage an inventory of moderate- to high-complexity commercial claims by verifying policy coverage, conducting investigations, developing and applying resolution strategies, and authorizing disbursements within authority limits.
• Provide professional and effective service to insureds, claimants, and business partners; meet quality and cycle-time standards, provide timely updates, and respond promptly to inquiries.
• Verify coverage and establish timely, adequate reserves by interpreting policy language, partnering with coverage counsel on complex matters, estimating claim value, and following claim-handling protocols.
• Investigate compensability, liability, and covered damages by gathering relevant information and documents, taking recorded statements, and working with experts or other parties as needed.
• Build and maintain working relationships with internal and external partners, suppliers, and experts to resolve claims effectively.
• Determine liability and compensability, negotiate settlements, authorize claim disbursements within authority limits, and escalate matters to a manager as appropriate.
• Manage expenses by resolving claims accurately and promptly, selecting and overseeing appropriate resources, and delivering high-quality service.
• Identify possible subrogation or salvage opportunities and potential fraud, and refer matters to Recovery or SIU resources for further investigation.
• Meet quality standards by following company guidelines, achieving quality and cycle-time targets, documenting files properly, and issuing appropriate disbursements.
• Maintain compliance with state and local regulatory requirements and stay current on commercial insurance laws, regulations, and trends for the line of business.
• May mentor or coach less experienced claim professionals.
• Perform additional duties as assigned.

Benefits

• Comprehensive and competitive benefits package intended to support employees’ and family members’ physical, financial, emotional, and social wellbeing.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level