Sr. Claim Representative

Claim Representative / Sr. Claim Representative

This position can be filled as a Claim Representative or Sr. Claim Representative based on experience. The Workers' Compensation Claim / Sr. Claim Representative is accountable for planning, recommending, and executing the investigation of workers' compensation claims. Our dynamic team of claim professionals provide superb customer service with the valuation, disposition and settlement of worker compensation claims while consistently adhering to our corporate claim settlement policies. Additionally, the representatives will work within established procedures in adherence to statutory, regulatory and ethical requirements.

Responsibilities:

• Effectively manage workers' compensation claims requiring timely investigations and financial accuracy
• Provide benefit oversight, appropriate file disposition and adherence to statutory guidelines for all claims
• Leverage a network of professional resources that may include: doctors, nurses, attorney and regulators to facilitate our mission of restoring the lives of our claimants
• Provide exceptional customer service by establishing and maintaining productive business relationships with customers
• Utilize critical thinking skills to gather and analyze data information to inform critical claim decisions
• Provide accurate mathematical calculations of disability benefit rates and claim financial exposures
• Leverage contemporary technology to achieve accurate and efficient claim outcomes
• Consistently demonstrate professional diplomacy during all interactions with customers
• Contribute to a courageous culture that promotes collaboration and inclusion to maximize operational performance and employee engagement
• Embrace a culture of continuous improvement

Qualifications:

Claim Representative:

• Prior workers' compensation insurance claim handling is preferred
• HS Diploma required, Bachelor's Degree is preferred
• Demonstrated passion for delivering a superb customer experience
• Excellent organizational skills, especially regarding prioritizing work activities
• Strong computer proficiency in the MS Office Suite (Word, Excel, Outlook & PowerPoint)
• Superb time management and organizational skills
• Ability to meet productivity targets in a fast-paced, team-oriented environment
• Excellent communication skills and negotiation skills
• Ability to adapt and flourish using industry-changing workflows
• Excellent written and verbal communication skills
• Demonstrates active listening to attentively meet the needs of our customers and exhibit empathy during difficult situations
• Demonstrated desire to promote an inclusive culture of continuous learning that is built on teamwork, collaboration, transparency, and accountability to one another
• Ability to self-manage competing priorities while delivering accurate work within key timelines

Sr. Claim Representative:

• Minimum of 2+ years of experience in Workers' Compensation claim handling required
• Certification exams and adjusting licenses as required by state
• Outstanding interpersonal skills
• Strong focus delivering outstanding customer service
• Demonstrated strong written and verbal communication skills
• Demonstrated consistent high level of performance and achievement over career span
• Excellent time management skills with the ability to manage competing priorities
• HS Diploma required, Bachelor's Degree is preferred

Additional Details:

This role can have a Hybrid or Remote work schedule. Candidates who live near one of our office locations will have the expectation of working in an office 3 days a week (Tuesday through Thursday). Candidates who do not live near an office will have a remote work schedule, with the expectation of coming into an office as business needs arise. As a condition of your employment, you must obtain and maintain a State Adjuster's License to process Property & Casualty Insurance. Continued employment with The *** is contingent upon the successful passage of the Licensing exam within 1 year from your date of hire.