Berkley

Claim Representative III

Location Name GA, Atlanta - 2 Ravinia Drive - Suite 1000
ID
2020-4429
Date Posted
2 months ago(11/24/2020 2:56 PM)
Company
Berkley Key Risk Management
Primary Location
US-GA-Atlanta
Loc2
North Carolina
Loc3
South Carolina
Loc4
Florida
Loc5
Alabama
Loc6
Tennessee
Category
Claims

Company Details

Key_Risk_Logo

In workers compensation, Responsiveness Matters. With over 30 years of expertise and 100% focus on workers compensation, Key Risk works with employers to create solutions specific to their needs. With an innovative approach to workers compensation, we create value through the relationships we develop, businesses we support and people we protect.

Employers who partner with Key Risk are provided dedicated risk management expertise and automatic access to workplace safety resources. In the event of an injury, our claims management approach provides employers with efficient claim handling, jurisdictional expertise and industry-leading results.

Our mission is to deliver innovative and responsive workers compensation solutions that provide our clients the freedom to do what they do best.

The Key Risk difference is Our Team.  Our associates are our greatest resource and define who and what we are, as well as what we can become.  We attract, select and retain people who are experts in their field.  We promote the growth and success of each associate through an ongoing commitment to innovation, continuous improvement and education.

Responsibilities

The Claims Professional is responsible for the analysis and management of workers’ compensation claims for assigned clients, including minor and complex claims.  This position will review, investigate, and make decisions regarding coverage, compensability, and appropriateness of claims.  The position will process and document claims to ensure compliance with company standards, industry best practices, and legislative provisions. Acts in a fiduciary role on behalf of policyholders and negotiates claim settlements. Claims Professionals conduct the handling of claims in the utmost of good faith in compliance with the rules, regulations and state statutes. Experience and the degree to which a claim professional can work independently to make sound decisions, reserve recommendations and drive outcomes will determine the hiring position, ranging from a Claim Representative I to a Senior Claim Representative. The Claims Professional is expected to function with a high degree of competency and independence. The use of sound judgment coupled with strong technical claim handling skills and consistent results are expected. 

 

Principle Responsibilities

  • Analyzes and processes workers’ compensation claims by investigating and gathering information to determine the exposure on the claim.
  • Negotiate settlement of claims up to designated authority level and makes claims payments.
  • Calculates and assigns timely appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim.
  • Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level.
  • Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
  • Prepares necessary state filings within statutory limits.
  • Actively manages the litigation process; ensures timely and cost-effective claims resolution.
  • Coordinates vendor referrals for additional investigation and/or litigation management.
  • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
  • Frequently communicates with all appropriate parties involved with the claim.
  • Maintains professional client relationships.
  • Actively executes appropriate claims activities to ensure consistent delivery of quality claims services.

Qualifications

  • Bachelor’s Degree
  • 2-10 years of workers compensation claims experience, preferable in Georgia
  • Georgia Adjuster license required
  • Moderate knowledge of appropriate insurance principles and laws of workers’ compensation, preferably jurisdiction specific.
  • Strong verbal and written communication
  • Strong interpersonal, time management and organizational skills.
  • Strong negotiation skills.
  • Proven critical thinking skills that demonstrates analysis/judgment and sound decision making with focus on attention to detail.
  • Ability to perform with a sense of urgency.
  • Ability to work both independently and within a team environment.
  • Ability to travel for business purposes, approximately less than 10%.

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