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Senior Claims Representative

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Company Details

With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results.

All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong), by S&P.

For further information about Key Risk please visit www.KeyRisk.com.

Responsibilities

The Senior Workers’ Compensation Claims Representative 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. Senior Claims Representative’s conduct the handling of claims in the utmost of good faith in compliance with the rules, regulations and state statutes. The Senior Claims Representative is expected to function with a degree of competency. The use of sound judgment coupled with strong technical claim handling skills and consistent results are expected.

Key functions include but are not limited to the following:

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.
Processes complex or technically difficult claims.
Calculates and assigns timely an 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.
Ability to assist team members to develop knowledge and understanding of claims practices.

Qualifications

BA/BS Degree
5+ years of workers compensation claims management experience
Adjuster license strongly desired or ability to obtain license within six months
In depth knowledge of appropriate insurance principles and laws of workers’ compensation, preferably jurisdiction specific.
Strong written and verbal communication skills.
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.

Additional Company Details

We do not accept unsolicited resumes from third party recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role

Average salary estimate

$87500 / YEARLY (est.)

min

max

$75000K

$100000K

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What You Should Know About Senior Claims Representative, Berkley

Are you ready to make a significant impact in the workers' compensation industry? Join Key Risk as a Senior Claims Representative in Blue Bell! With over 35 years of experience, Key Risk is known for delivering innovative and tailored solutions to clients, allowing them to thrive. In this dynamic role, you will be the crucial link in managing both minor and complex workers' compensation claims for your assigned clients. Utilizing your analytical skills, you will investigate claims and make informed decisions regarding coverage and compensability while ensuring compliance with company standards. Your negotiation skills will come into play as you settle claims and manage financial reserves, all while maintaining clear communication with clients and colleagues. Your expertise will guide you in processing technically challenging claims and managing the litigation process. At Key Risk, we believe in developing our employees, and you’ll have the chance to assist team members in understanding best practices in claims management. Bring your strong critical thinking skills and sense of urgency to a company that values professionalism and service excellence. In return, we offer a competitive compensation plan and a robust benefits package to support you and your career growth. If you're driven by helping others navigate their claims effectively, then the Senior Claims Representative position at Key Risk is the perfect opportunity for you!

Frequently Asked Questions (FAQs) for Senior Claims Representative Role at Berkley

What are the key responsibilities of a Senior Claims Representative at Key Risk?

As a Senior Claims Representative at Key Risk, your primary responsibilities include analyzing and managing workers' compensation claims, conducting thorough investigations, making coverage decisions, and negotiating settlements within your authority limits. You'll be responsible for processing complex claims, managing reserves throughout the claim lifecycle, and ensuring compliance with industry standards and regulations.