Let’s get started
By clicking ‘Next’, I agree to the Terms of Service
and Privacy Policy, and consent to receive emails from Rise
Jobs / Job page
Sr. Workers Compensation Claims Representative - CA, NV, AZ image - Rise Careers
Job details

Sr. Workers Compensation Claims Representative - CA, NV, AZ

Company Details

 

BerkleyNet is an innovative workers compensation insurance provider that does all our business online. Our Goal? To make doing business “Ridiculously Fast. Amazingly Easy.”

Responsibilities

As a Claims Representative, you will be responsible for the investigation, evaluation, mitigation and resolution of medical only and lost time workers’ compensation claims of moderate complexity in multiple jurisdictions.

  • Investigate workers’ compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due
  • Calculate and set timely financial reserves and proactively manages reserve adequacy throughout claim lifecycle
  • Record and code injured worker demographics, job information and accident information in company’s claims management system and files necessary forms with state regulatory agencies
  • Issue timely payments to injured workers, medical providers and service vendors
  • Coordinate and actively manage medical treatment of injured workers to ensure timely rehabilitation
  • Negotiate settlements of claims within designated authority with injured workers and attorneys
  • Demonstrate a working knowledge of the Workers’ Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions
  • Identify and manage subrogation, Second Injury Fund and joint coverage recovery opportunities
  • Regularly communicate claim activity and status updates to policyholders, injured workers and other interested parties in a professional, thoughtful and tactful manner
  • Respond in a timely manner to communications from policyholders, injured workers, and other interested parties
  • Notify management and develops reports for large exposure claims and complies with reinsurance reporting requirements
  • Manage the claims litigation process to ensure timely and cost-effective claims resolution
  • Monitor the expenses and effectiveness of managed care and investigation vendors
  • Actively participate in special projects as assigned by management
  • Periodically travel to attend hearings, conferences and training sessions
  • Attend and participates in claim file reviews with management and defense attorneys
  • Continuously strives to improve our product and business results through innovation
  • Obtain and maintain adjuster licenses in assigned jurisdictions where required

 

Qualifications

  • Excellent written and verbal communication skills
  • Strong interpersonal and relationship building skills
  • Exceptional time management and organization skills
  • Strong analytical and critical thinking skills
  • Ability to work independently and strategically problem solve
  • Ability to diplomatically manage conflict
  • Ability to develop relationships within the organization and work effectively across departments
  • Strong discretion and integrity in dealing with highly confidential and sensitive information
  • Detail oriented

Education

  • Bachelors’ degree or equivalent insurance industry work experience

Additional Company Details

The Company is an equal employment opportunity employer. For a qualified candidate with jurisdiction experience with CA, AZ & NZ claims, the team will consider remote candidates. We do not accept any unsolicited resumes from external recruiting firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. Base salary & Benefits include Health, dental, vision, life, disability, wellness, paid time off, 401(k) and profit-sharing plans. Base Salary Range: 65k - 95k 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.

Additional Requirements

• Low level of domestic U.S. travel required (up to 5% - 10% of time)

Average salary estimate

$80000 / YEARLY (est.)
min
max
$65000K
$95000K

If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.

Similar Jobs
Posted 3 days ago

Explore the world of insurance data as a Data Engineering Intern with W. R. Berkley Corporation, gaining invaluable hands-on experience in a dynamic IT environment.

Berkley Hybrid Chicago
Posted 2 days ago

Join Vela Insurance Services as an Accountant and play a critical role in maintaining accurate financial information and support regulatory reporting.

Photo of the Rise User
ServiceNow Hybrid 201 West 5th Street, 11th Floor, Austin, TEXAS, United States
Posted 13 days ago
Inclusive & Diverse
Mission Driven
Rise from Within
Diversity of Opinions
Work/Life Harmony
Empathetic
Feedback Forward
Take Risks
Collaboration over Competition
Medical Insurance
Dental Insurance
Vision Insurance
Mental Health Resources
Life insurance
Disability Insurance
Health Savings Account (HSA)
Flexible Spending Account (FSA)
Conferences Stipend
Paid Time-Off
Maternity Leave
Equity

As a Senior Customer References Associate at ServiceNow, you will drive customer advocacy and reference management to support sales and marketing initiatives.

Posted 8 days ago

Join Dignity Health Medical Group as a Medical Receptionist and play a crucial role in providing exceptional patient service.

Posted 13 days ago

Join Virginia Mason Franciscan Health as an Echo Technologist and be a part of a team dedicated to providing exceptional healthcare in the Puget Sound area.

Join Desert Valley Medical Group as a Medical Assistant/Scribe to support our healthcare providers and ensure excellent patient care.

Join the University of Rochester as a Nurse Manager to lead a dedicated team in providing exceptional patient care in the Pain Treatment Center.

Photo of the Rise User

Join St. Luke’s Health System as a Telehealth Patient Management Specialist to support patients in managing chronic conditions.

Hy-Vee Hybrid Oskaloosa, D Street, Oskaloosa, IA
Posted 13 days ago

Be a pivotal part of the Hy-Vee team as a Food Service Manager, focusing on customer satisfaction and leading a dynamic kitchen staff.

New LHRC External Career Site Hybrid Chatham, Virginia, United States
Posted 14 days ago

Become an essential part of the Pittsylvania County Department of Social Services as an Office Associate III, contributing to administrative functions and customer interactions.

Photo of the Rise User

Join Summit LTC as an Activities Assistant, where your role will help foster joy and enrich the lives of residents.

Photo of the Rise User

Join Emory Healthcare as a Patient Arrival Specialist and be the first point of contact for patients, ensuring a welcoming experience.

Photo of the Rise User

Become part of NIQ as a Bilingual Customer Service Representative, providing exceptional support in a flexible part-time remote setting.

Photo of the Rise User
Posted 12 days ago

Become a leader in the Service Management team at Thomson Reuters, overseeing technical support operations and driving continuous improvement.

Photo of the Rise User
Brightflag Hybrid New York, United States
Posted 3 days ago
Dental Insurance
Flexible Spending Account (FSA)
Health Savings Account (HSA)
Vision Insurance
Paid Holidays
Sabbatical

Brightflag is looking for a skilled Customer Success Manager to ensure enterprise clients derive maximum value from our innovative legal management solutions.

MATCH
Calculating your matching score...
FUNDING
SENIORITY LEVEL REQUIREMENT
TEAM SIZE
No info
HQ LOCATION
No info
EMPLOYMENT TYPE
Full-time, hybrid
DATE POSTED
April 23, 2025

Subscribe to Rise newsletter

Risa star 🔮 Hi, I'm Risa! Your AI
Career Copilot
Want to see a list of jobs tailored to
you, just ask me below!
LATEST ACTIVITY
Photo of the Rise User
8 people applied to Cashier (Part-time) at Datadog
Photo of the Rise User
Someone from OH, Cleveland just viewed Contracts Assistant at Macmillan Learning