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Claims processor • high point nc
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Claims Representative II
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W. R. BerkleyHigh Point, NC, United States- serp_jobs.job_card.promoted
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W.R. BerkleyHigh Point, NC, US- serp_jobs.job_card.full_time
Claims Professional
Key Risk is looking for a claims professional who enjoys analysis and management of workers compensation claims.
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.
- Negotiates settlement of claims up to designated authority level and makes claims payments.
- 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.
Qualifications :
Additional Company Details :
We do not accept any unsolicited resumes from external 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