Find Jobs
Find Jobs Near You – Available Work in Your Location
Skip to job details
B
Berkley
WC Claims Examiner
Career Insights for Claims Examiner (General)
See where this job fits in the broader career landscape. Knowing your career path helps you see what's possible from here.
Scorecard
Based on Minnesota data
Review key factors to help you decide if this role fits your goals. How is this calculated?
What they do
A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.
$78,618 / year median in Minnesota
-2% projected decline
Job Description
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 To perform workers' compensation claims adjudication and investigation. Responsible for all technical aspects of claim management for assigned claims including compliance with all established performance guidelines. 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. Additional Company Details The Company is an equal employment opportunity employer. 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.