Sr. Claims Representative

Manassas, VA
Jul 29, 2022
Aug 08, 2022
Accountant, IT
Full Time
Company Details: BerkleyNet is an innovative workers compensation insurance provider that does all of our business online. Our Goal? To make doing business "Ridiculously Fast. Amazingly Easy." Responsibilities: The Sr. Claims Representative is responsible for the investigation, evaluation, mitigation and resolution of an inventory of lost time and catastrophic workers' compensation injury claims in multiple jurisdictions. This role would ideally be located in our Manassas, VA offices which has a Hybrid work environment (3 days in office). Would consider fully remote work for the right experience. #LI-RemoteInvestigates workers' compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits dueCalculates and sets timely financial reserves and proactively manages reserve adequacy throughout claim lifecycleRecords and codes injured worker demographics, job information and accident information in company's claims management system and files necessary forms with state regulatory agenciesIssues timely payments to injured workers, medical providers and service vendors Coordinates and actively manages medical treatment of injured workers to ensure timely rehabilitationNegotiates settlements of claims within designated authority with injured workers and attorneysServes as their team's subject matter expert of the Workers' Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictionsIdentifies and manages subrogation, Second Injury Fund and joint coverage recovery opportunitiesRegularly communicates claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful mannerNotifies management and develops reports for large exposure claims and complies with reinsurance reporting requirementsManages the litigation process to ensure timely and cost-effective claims resolutionMonitors the expenses and effectiveness of managed care and investigation vendorsPeriodically travels to attend hearings, conferences and training sessionsAttends and participates in claim file reviews with management and defense attorneysCoordinates and leads special projects or processes as assigned by managementAssists with oversight and supervisory duties when the team supervisor is unavailable or as assigned by supervisorSupports management with training and staff development Supports management with vendor management activitiesContinuously strives to improve our product and business results through innovationTakes ownership of continuing education and career development through proactive completion of continuing education programs and trainings for professional and personal developmentObtain and maintain adjuster license in multiple jurisdictions Qualifications: Bachelors' degree or equivalent insurance industry work experienceAIC, ARM, CCP, or CPCU insurance designation preferredMinimum 2 years of experience (3 - 5 years preferred) handling workers' compensation claimsAbility to travel required (<10% of time) nationally to attend legal hearings, conferences, trainings and claim file reviewsExcellent written and verbal communication skillsStrong interpersonal and relationship building skills Exceptional time management and organization skillsStrong analytical and critical thinking skillsAbility to work independently and strategically problem solveAbility to diplomatically manage conflictAbility to develop relationships within the organization and work effectively across departmentsStrong discretion and integrity in dealing with highly confidential and sensitive informationDetail oriented Additional Company Details: *The Company is an equal employment opportunity employer Additional Requirements: *Must be fully vaccinated and remain fully vaccinated against COVID-19, unless prohibited by law.* *Per the CDC, fully vaccinated means at least 2 weeks after (1) a second dose in a 2-dose series, or (2) a single-dose vaccine, and this status and definition applies to COVID-19 vaccines currently authorized for emergency use or approved by the US Food and Drug Administration