Company Details
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
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.
- 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.
May perform other functions as assigned
Qualifications
- 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.
Education
- College degree or relevant experience