Workers Compensation Sr. Claims Examiner - Minnesota

Berkley•Overland Park, KS

4d•Hybrid

About The Position

This position is responsible for managing a caseload of incoming and complex workers' compensation cases, including extended disability, litigation, employer's liability claims, and assigned claims. The role involves all technical aspects of claim management, ensuring compliance with performance guidelines, investigating claims, making decisions on compensability, and documenting claim handling activities. The examiner will establish case reserves, actively manage medical treatment and disability to assist injured workers in returning to work, and identify loss trends. A diary system will be used for indemnity payments and claims management, and the role includes managing claim subrogation, negotiating settlements, and handling coverage B or conflict of interest cases. The examiner will also address customer complaints professionally and may participate in client claim reviews. Remote work may be considered for highly qualified candidates residing more than 50 miles from Minneapolis, with the requirement to travel to Minneapolis as needed.

Requirements

Demonstrated working knowledge of workers’ compensation administration rules/laws in at least one of the following states: MN, IL or WI.
Excellent communication and presentation skills.
Must be able to interface with clients, legal counsel, health care professionals, etc.
Good math and analytical ability.
Excellent customer service skills.
Basic PC skills and a working knowledge of Windows environment.
Experience with a client/server based claims processing system.
BA/BS degree with three years’ experience, including litigation, subrogation and complex medical/legal issues OR two years post-high school education and five years’ experience in workers compensation claims management.

Responsibilities

Manage a caseload of incoming and complex workers' compensation cases, including extended disability, litigation, employer's liability claims, and assigned claims.
Perform all technical aspects of claim management for assigned files, ensuring compliance with established performance guidelines.
Investigate claims and make appropriate decisions regarding claim compensability and general claims management.
Document claim handling activities and create/document action plans.
Establish appropriate case reserves.
Actively manage medical treatment and disability while assisting the injured worker to return to work.
Comply with all performance guidelines.
Identify loss trends and communicate them to the supervisor and/or clients.
Use automated diary system to issue indemnity payments and for claims management.
Investigate and manage claim subrogation and negotiate settlements.
Manage coverage B or conflict of interest cases as assigned.
Address customer complaints and inquiries in an exemplary and professional manner.
Participate in client claim reviews when scheduled or requested.
May perform other functions as assigned.