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Acadia Insurance (a Berkley Company) · 3 months ago

Claims Representative II

US-NC-High Point

Full-time

Onsite

Entry, Mid Level

2+ years exp

Acadia Insurance, a Berkley Company, is seeking a claims professional to manage and analyze workers compensation claims. The role involves investigating claims, negotiating settlements, and ensuring timely resolution while maintaining professional client relationships.

Commercial InsuranceInsurance

No H1B

Responsibilities

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

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

Qualification

Workers compensation claimsAdjuster licenseInsurance principlesNegotiation skillsCommunication skillsInterpersonal skillsTime managementOrganizational skillsCritical thinkingTeamwork