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Claims Representative

Employer
WR Berkley Corporation
Location
Manassas, VA
Closing date
Jul 27, 2021

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Industry
Insurance
Function
Accountant, IT
Hours
Full Time
Career Level
Experienced (Non-Manager)
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." Job Description The Senior Claims Representative is responsible for the investigation, evaluation, mitigation and resolution of an inventory of medical only and low complexity lost time workers' compensation claims in multiple jurisdictions. Overall Responsibilities * Investigates workers' compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due * Calculates and sets timely financial reserves and proactively manages reserve adequacy throughout claim lifecycle * Records and codes injured worker demographics, job information and accident information in company's claims management system and files necessary forms with state regulatory agencies * Issues timely payments to injured workers, medical providers and service vendors. * Coordinates and actively manages medical treatment of injured workers to ensure timely rehabilitation * Negotiates settlements of claims within designated authority with injured workers and attorneys * Maintains and demonstrates knowledge of the Workers' Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions * Identifies and manages subrogation, Second Injury Fund and joint coverage recovery opportunities * Regularly communicates claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful manner * Notifies management and develops reports for large exposure claims and complies with reinsurance reporting requirements * Manages the litigation process to ensure timely and cost effective claims resolution * Monitors the expenses and effectiveness of managed care and investigation vendors * Actively participates in special projects as assigned by management * Periodically travels to attend hearings, conferences and training sessions * Attends and participates in claim file reviews with management and defense attorneys * Continuously strives to improve our product and business results through innovation * Completes continuing education and career development programs and training with guidance from supervisor * Obtain and maintain adjuster license in multiple jurisdictions as required Required Skills & Competencies * Managing Self * Effective Collaboration * Evidence-Based Decision Making * Reflective Listening * Courage * Resilience * Challenge the Status Quo Additional Qualifications * Excellent written and verbal communication skills * Strong interpersonal and relationship building skills * Exceptional time management and organization skills * Strong analytical and critical thinking skills * Ability to diplomatically manage conflict * Ability to develop relationships within the organization and work effectively across departments * Strong discretion and integrity in dealing with highly confidential and sensitive information * Detail oriented Travel Requirements * Low level of travel required (<10% of time) * Ability to travel nationally to attend hearings, conferences and trainings Physical Requirements * While performing the duties of this job, the employee is regularly required to be seated for sustained periods of time; be able to use a keyboard; pick-up, pinch, or twist objects; must be able to communicate information accurately; distinguish sounds at normal levels and be able to receive information orally. The employee is occasionally required to move about the office to accomplish tasks; reach in any direction; raise or lower objects or move objects from place to place; and hold onto objects. Occasionally, the employee may need to move or exert force up to ten (10) pounds. The employee is regularly required to operate a computer and other office equipment, including a phone, copier and printer. Education * Bachelors' degree or equivalent insurance industry work experience The above job description is not intended to be an "all-inclusive" list of the duties and responsibilities of the job described, nor is it intended to be such a listing of the skills and abilities required to do the job. Rather, it is intended only to describe the general nature of the job.#06022021

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