Claims Specialist

Claims Specialist

The Claims Specialist under the supervision of the Director of Claims is responsible for proactively investigating, managing, and resolving Workers' Compensation, General Liability, and Automobile Liability claims. The Claims Specialist will timely and accurately process all claims from filing to closure in accordance with Suffolk Construction Company, Inc., best practices and state regulations. The Claims Specialist will work closely with Suffolk's carriers, brokers, operations team, and attorneys to achieve the best possible outcome for each claim. The Claims Specialist will assist in the implementation and maintenance of processes and procedures to eliminate, mitigate, and control the financial impacts of losses across several lines of business.

Responsibilities:

• Review, investigate, analyze and adjust claims in accordance with current laws and regulations.
• Report new incidents to the appropriate insurance carriers.
• Assist with risk transfer efforts, including drafting tender letters.
• Establish and maintain working relationships with claimants, employees, medical providers, Suffolk's insurance broker, insurance carriers and outside defense counsel to ensure timely and accurate liability decisions.
• Determine when vendor involvement is necessary, such as medical case management, vocational rehabilitation counseling, legal, surveillance, etc. and direct and monitor the vendor services to ensure the effective cost containment of expenses on claims.
• Initiate "Three-Point Contact" with Suffolk's insurance carrier(s), injured employee, and medical provider.
• Initiate, coordinate and ensure early return to work efforts.
• Review progress of claims internally, providing a well-documented action plan.
• Attend conferences, hearings, and mediations as necessary to properly administer resolution of claims.
• Perform monthly job-site visits to engage operations in the claims process, meet with employees and subcontractors, and perform site safety checks.
• Stay apprised of current changes in the law, court rulings and related matters that might affect the handling of claims.
• Act as an internal claims resource to assist with investigating and compiling data and financial information to support Suffolk's position on claims.
• Participate in the administration of CCIP claims.
• Assist with discovery responses for litigated matters.
• Assist the claims, legal, risk, and operations departments with other duties as assigned.
• Pursue ongoing professional development opportunities.

Qualifications

• Education: Bachelor's degree
• Experience: 3-5 years of claims management experience or similar background in insurance industry and/or construction industry.
• Knowledge of workers' compensation laws and guidelines. (Preferred)
• Knowledge of legal and medical terminology. (Preferred)
• Knowledge of insurance claims adjusting. (Preferred)
• Excellent working knowledge of Excel, Word and Power Point.

Necessary Attributes

• Actively participate as a team member within the Claims Department and with all departments within the company.
• Excellent written and verbal communication skills.
• Highly developed interpersonal skills.
• Ability to prioritize multiple demands in a fast paced, changing work environment.
• Initiative to meet designated time tables with minimum supervision.
• Detail oriented.

Working Conditions

While performing the duties of this job, the employee is regularly required to sit for long periods of time; talk or hear; perform fine motor, hand and finger skills in the use of a keyboard, telephone, or writing. The employee is frequently required to stands; walk; and reach with arms and/or hands. Specific vision abilities include close vision, distance vision, depth perception and the ability to adjust focus. The employee will spend their time in an office environment with a quiet to moderate noise level. Job site walking.

EEO Statement

Suffolk provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, pregnancy or maternity, national origin, citizenship, genetic information, disability, protected veteran, gender identity, age or any other status protected by law. This policy applies to recruiting, hiring, transfers, promotions, terminations, compensation, benefits, and all other terms and conditions of employment. Suffolk will not tolerate any unlawful discrimination toward, or harassment of, applicants or employees by anyone at Suffolk, or anyone working on behalf of Suffolk.

Compensation Information

Where required by law, pay ranges can be found in Suffolk's job postings. Base Salary for this position is just one component of Suffolk's total rewards package for employees. Actual salaries may be based on several factors including, but not limited to, a candidate's skill set, experience, education and other qualifications. Suffolk offers a comprehensive benefits package as part of its overall total rewards strategy. Salary ranges are reviewed regularly to reflect market trends.