Berkley

WC Claims Examiner

Location Name MN, St. Paul - 145 University Avenue West
ID
2021-5691
Date Posted
2 weeks ago(1/5/2022 2:55 PM)
Company
Berkley Risk Admin. Co., LLC
Primary Location
US-MN-Saint Paul
Category
Claims

Company Details

Berkley_Risk_Admin_Logo

 

We’re a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.

Responsibilities

The Workers Compensation Claims Examiner performs claims adjusication and investigation.  The role is responsible for all technical aspects of claim management for assigned including compliance with all established performance guidelines.

 

Responsibilities include but are not limited to the following:

  • 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.
  • Define medical and rehabilitation payment parameters staff.

Qualifications

  • College degree or relevant experience
  • 1 – 2 years minimum 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.

 

Berkley Core Competencies

Communication

Customer Focus and Teamwork

Flexibility

Delivers Results

Technical & Job Excellence

Accountability

Additional Company Details

The Company is an equal employment opportunity employer.

Additional Requirements

COVID-19 vaccine required unless prohibited by law.

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