Claims Representative

Workers Compensation Claims InvestigatorBerkleyNet is an innovative workers compensation insurance provider that does all of our business online. Our Goal? To make doing business "Ridiculously Fast. Amazingly Easy."ResponsibilitiesInvestigate workers' compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits dueCalculate and set timely financial reserves and proactively manage reserve adequacy throughout claim lifecycleRecord and code injured worker demographics, job information and accident information in company's claims management system and files necessary forms with state regulatory agenciesIssue timely payments to injured workers, medical providers and service vendorsCoordinate and actively manage medical treatment of injured workers to ensure timely rehabilitationNegotiate settlements of claims within designated authority with injured workers and attorneysServe as the team's subject matter expert of the Workers' Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictionsIdentify and manage subrogation, Second Injury Fund and joint coverage recovery opportunitiesRegularly communicate claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful mannerNotify management and develop reports for large exposure claims and comply with reinsurance reporting requirementsManage the claims litigation process to ensure timely and cost-effective claims resolutionMonitor the expenses and effectiveness of managed care and investigation vendorsPeriodically travel to attend hearings, conferences and training sessionsAttend and participate in claim file reviews with management and defense attorneysCoordinate and lead special projects or processes as assigned by managementAssists with oversight and supervisory duties when the team supervisor is unavailable or as assigned by supervisorSupport management with training and staff developmentSupport management with vendor management activitiesContinuously strives to improve our product and business results through innovationObtain and maintain adjuster license(s) in assigned jurisdictionsQualifications3 - 5 years of experience handling workers' compensation claimsExcellent written and verbal communication skillsStrong interpersonal and relationship building skillsExceptional 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 orientedEducationBachelors' degree or equivalent insurance industry work experienceAIC, ARM, CCP, or CPCU insurance designation preferredAdditional Company DetailsThe Company is an equal employment opportunity employer. We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. Base salary & Benefits include Health, dental, vision, life, disability, wellness, paid time off, 401(k) and profit-sharing plans. Salary Range: 65k - 95k The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.Additional Requirements• Low level of domestic U.S. travel required (up to 5% - 10% of time)