Claims Representative (Workers Comp)

Job Title Take ownership of complex workers comp claims from initial investigation through resolution, using your experience and judgment to make sound coverage, liability, and settlement decisions. Job Description This is an active claims desk, strong organization, time management, and the ability to effectively prioritize a busy workload are important to success. Work Location This position offers both remote and hybrid work locations. Candidates who reside within 50 miles of an office location (West Bend, Madison, Appleton) will be offered a hybrid work schedule. Candidates who are fully remote (beyond 50 miles) may occasionally be asked to travel to an office location for in-person engagement activities such as team meetings, training and corporate events. Responsibilities & Qualifications Take ownership of complex workers comp claims from initial investigation through resolution, using your experience and judgment to make sound coverage, liability, and settlement decisions. This is an active claims desk, strong organization, time management, and the ability to effectively prioritize a busy workload are important to success. In this role, you'll: Manage complex and higher-exposure workers comp claims with minimal supervision. Research policy language and develop well-supported coverage decisions. Conduct thorough investigations and evaluate liability, damages, reserves, and settlement strategy. Negotiate effectively with insureds, claimants, attorneys, and other involved parties. Oversee litigated files and partner with counsel to develop appropriate resolution strategies. Proactively manage a busy caseload while maintaining accurate reserves, timely follow-up, and strong file documentation. Present complex claims to Committee and clearly communicate recommendations. Collaborate with teammates and internal partners to resolve claims effectively. Serve as a resource and mentor to others on the Claims team. Deliver a high level of customer service while meeting department quality and audit standards. Preferred Experience and Skills We're looking for an experienced claims professional who is comfortable managing a fast-moving, active desk and brings strong judgment, communication, and collaboration skills. Prior experience handling large, complex, or higher-exposure claims. Excellent written and verbal communication skills. Strong investigation, negotiation, and problem-solving skills. Strong time management, organization, and prioritization skills. Team-oriented approach and willingness to collaborate and support others. Strong interpersonal skills and the ability to work effectively with insureds, claimants, attorneys, and internal partners. Comfort working independently and making decisions while knowing when to collaborate or escalate. Proficiency with claims technology and other computer-based tools. Experience handling claims in Nebraska, Kansas, and/or Missouri is preferred. Experience in Kansas and Missouri is especially valuable as we continue to grow in these markets. Preferred Education and Training Bachelor's degree in Business, Insurance, or a related field. Associate in Claims (AIC) designation. Associate in General Insurance (AINS) designation. CPCU coursework or other relevant insurance education or continuing professional development. Salary Statement The salary range for this position is $70,000-$90,000. The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity. Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate. Benefits West Bend offers a comprehensive benefit plan including but not limited to: Medical & Prescription Insurance Health Savings Account Dental Insurance Vision Insurance Short and Long Term Disability Flexible Spending Accounts Life and Accidental Death & Disability Accident and Critical Illness Insurance Employee Assistance Program 401(k) Plan with Company Match Pet Insurance Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates Bonus eligible based on performance West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies. EEO West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion. The Silver Lining