Berkley

  • Claims Examiner

    Location Name MN, Minneapolis - 222 S 9th Street - Suite 2700
    ID
    2018-2045
    Date Posted
    2 weeks ago(11/1/2018 3:16 PM)
    Company
    Berkley Risk Admin. Co., LLC
    Primary Location
    US-MN-Minneapolis
    Category
    Claims
  • Company Details

    Berkley Risk is a national provider of at-risk and alternative risk insurance program management services. We are a one-stop, total insurance management solution for Pools, Captives, Trusts, RRGs, RPGs and other individual and group self-insureds.

     

    As program manager we provide transparent, turn-key insurance solutions that simplify the insurance process and minimize our customers’ total cost of risk over the long term.

     

    We are a member company of W.R. Berkley Corporation, a Fortune 500 holding company.

    Responsibilities

    To perform workers’ compensation claims adjudication and investigation. Responsible for all technical aspects of claim management for assigned files including compliance with all established performance guidelines.

     

    ESSENTIAL RESPONSIBILITIES/FUNCTIONS:

    • Properly investigate and handle all types of workers’ compensation files including lost time, litigation and long term exposure within predetermined claim-handling guidelines.
    • Initiate return-to-work discussions with the employer and effect return-to-work for the injured worker.
    • Establish timely and appropriate case reserves
    • Investigate and manage subrogation and negotiate settlements.
    • Use automated diary system to issue indemnity benefits and provide claim management.
    • Accurately calculate and pay wage loss and other benefits.
    • Assign rehabilitation and monitor costs and outcomes.
    • Document all action plans and evaluations for claim resolution.
    • Maintain organized electronic files.
    • Interact with clients to establish/improve communication and service capabilities.
    • Interact and communicate with state agencies, attorneys and other providers.
    • Address customer complaints and inquiries in an exemplary and professional manner.
    • Achieve specific performance outcomes related to quality and quantity of work as established by management.
    • Provide cost containment for individual claim and overall claim costs for account to achieve account profitability.
    • Approve medical and rehabilitation payments for check entry staff or define medical and rehabilitation payment parameters for WC Claim Technicians per office procedure.
    • Conduct in person claim reviews when scheduled or requested.
    • Perform the duties noted in the position descriptions in accordance with the BRAC Claim Handling Guidelines - Workers' Compensation
    • Occasional travel may be out of town requiring overnight stay. 

    May perform other functions as assigned.

    Qualifications

    The following education, experience and skills requirements are necessary to perform the essential functions of this position. 

    • High school diploma (or equivalent) plus a minimum of two years workers’ compensation claim processing experience or BA/BS degree with one year workers’ compensation claim processing experience.
    • Experience must include handling of medical-only, lost-time and litigated claims.
    • Demonstrated working knowledge of workers’ compensation administration rules/laws.
    • Good to excellent math and analytical ability.
    • Good to excellent oral and written communication skills.
    • Excellent customer service skills.
    • Must maintain a valid driver’s license and carry vehicle insurance coverage.

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