Claims Representative I (Workers' Compensation)

Claims Representative I (Workers' Compensation) Location: Full Time – Fond du Lac, WI, US Requisition details have been removed for ATS clarity. Job Information Job Title Claims Representative I (Workers’ Compensation) Home Department Claims Employment Status Exempt; Full-time Schedule 40 hours/week with Flexible Scheduling Opportunities Position Location Home Office, Hybrid, and Remote Opportunities in: CO, GA, IL, IN, IA, MN, TN, TX, WI Overview Society Insurance seeks a Claims Representative I (Workers’ Compensation) to investigate, evaluate, and resolve mildly complex claims by determining coverage and liability, coordinating with injured workers, employers, and medical providers, and negotiating resolutions in accordance with company guidelines, policy provisions, and state regulations. About the Role Handles and settles mildly complex claims by determining carrier liability, reaching agreement with claimants/injured workers according to policy provisions and authority, and handling subrogation. Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants/injured workers, insureds, and witnesses; reviewing police and hospital records; and consulting with experts when appropriate. Resolves questionable claims by investigating and comparing claims information with evidence. Ensures company guidelines and procedures are followed during investigations and in the handling of discovery and settlement. Ensures proper file documentation by complying with claims handling guidelines and state requirements. Prepares reports by collecting, analyzing, and summarizing claim information. Develops and maintains professional, technical knowledge and expertise in a specified line(s) of business through training courses and continuing education. Contributes to team effort by helping determine department investigation guidelines and providing feedback to underwriting as needed. About You You enjoy communicating and building relationships with others. You are composed, cool under pressure, and can negotiate without damaging relationships. You hold yourself accountable and act in accordance with rules and regulations. You enjoy analyzing, investigating, and using the facts to make decisions. You are naturally curious and have a desire to know more. You apply an investigative approach to identifying facts and evaluating evidence. What it Will Take Bachelor’s Degree in business or related field OR 3+ years of claims handling experience involving discretionary decision-making. OR 5+ years of knowledge in the property & casualty insurance industry. Familiarity with PC applications including word processing, Internet, spreadsheets, and e-mail. Ability to obtain and maintain proper licensing prior to handling a state that requires it. Valid driver’s license and a satisfactory driving record as determined by Society Insurance. Prior workers’ compensation indemnity experience highly desirable. What Society Can Offer Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options Education: Career Coaching; company-paid courses; student loan and tuition reimbursement Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Equal Employment Opportunity Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, disability, genetics, veteran status, marital status, sexual orientation, gender identity or expression, or any other characteristic protected by law. Society Insurance provides reasonable accommodations to qualified individuals with disabilities in accordance with applicable laws. Society Insurance is a drug-free workplace. #J-18808-Ljbffr Society-Insurance