Sr. Workers Compensation Claims Examiner - Berkley

Company Details:

 

At Berkley Entertainment, we have over 25 years of underwriting risks in Entertainment & Sports.  Our one focus is entertainment insurance. We bring our decades of entertainment experience together to go beyond the basics, providing crafted coverage solutions to protect our clients.

 

Our team’s industry experience and collaborative approach leads to great client solutions — and this is by design. We are here to assist with customizing products and services that are tailored to respond to each client’s unique exposures.

 

The company is an equal opportunity employer. 

Responsibilities:

The Workers Compensation Litigation Specialist reviews, evaluates, negotiates, and processes Workers Compensation losses that involve legal inquiry or dispute. The ability to develop a strategy to bring losses to a satisfactory resolution. Interface with agents, policy holders and defense in controlling costs and loss ratios. 

 

Key functions include but are not limited to:

• Analyzes and processes litigated workers' compensation claims by investigating and gathering information to confirm coverage is in place for the loss and that the loss itself is compensable per California specific requirements.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Promptly and accurately completes required internal Large Loss reports
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments.
• Prepares necessary state fillings within statutory limits.
• Proactively manage all litigated claims by clearly documenting the litigation plan and budget, retaining competent counsel, communicating with counsel on a regular basis and clearly documenting the litigation action plan and strategy. 
• 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 for our clients.
• Negotiates settlement of claims within designated authority.
• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Assume full responsibility for all phases of account management for accounts as assigned and inform management of any unfavorable trends.
• Participate in claim reviews, which may require some travel.

Qualifications:

• BA/BS degree in a related field of study
• 5 to 10 years of experience in investigating and adjusting workers compensation claims.
• Texas or California Adjuster License required in area of adjusting specialty.
• Extensive understanding of WC Statutory benefits and state regulatory requirements in California preferred.
• Demonstrates strong written and oral communications skills.
• Ability to draft communications that are clear, concise, complete and professional.
• Negotiation skills mandatory, and ability to interact with all levels of the organization.
• Demonstrates organizational skills while working on multiple projects.
• Working knowledge of Excel, Word, and general computer skills.

Additional Company Details:We do not accept any unsolicited resumes from external recruiting agencies. 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