Responsibilities
The Senior Workers' Compensation Claims Representative is responsible for investigating, evaluating, and resolving assigned workers' compensation claims in accordance with company standards, procedures, and state regulatory requirements.
• Investigate, evaluate and resolve claims in accordance with company standards, procedures, and state regulatory requirements.
• Analyze and determine specific facts of loss to reach appropriate decisions and effectively communicate the company's compensability decisions.
• Compose a variety of written communications to insureds, claimants, attorneys and agents in a professional and error-free manner.
• Conduct detailed, comprehensive claim investigations including possible on-site scene examinations and in-person witness interviews when appropriate and necessary.
• Evaluate and document exposure to ensure accurate and timely reserves; immediately escalate to management cases with significant exposure.
• Negotiate effectively and in good faith to achieve fair and accurate claim settlements.
• Proactively manage litigated claim files from inception to closure, including collaboration with defense counsel to determine and execute an appropriate plan of action; bring litigated cases to resolution either by negotiated settlement or hearing decisions, as appropriate.
• Retain vendors to achieve appropriate claim outcomes while remaining mindful of loss adjustment expenses.
• Manage assigned workloads effectively to achieve quality and quantity production goals while providing superior customer service.
• Effectively present cases in roundtable discussions with peers and members of management at all levels.
• Appropriately and clearly document all notes and file activity in a paperless claim system; compose detailed periodic reports including claim summary reports and large loss notifications.
• Communicate with other departments regarding developments on specific claim files as well as overall claim trends relevant to Acadia's business.
• Maintain a strong relationship and frequent communication with Acadia's agency partners.
• Work proficiently with various computer programs including MS Word, Excel, and other applications used in the claim handling process.
• Attend internal and external seminars and other training events and provide feedback to peers and/or members of management.
• Obtain all required state adjuster licenses and maintain them as needed by complying with continuing education requirements.
• Pursuit of industry-related professional designations is encouraged.
• Perform other duties as assigned.
Qualifications
Qualifications:
• 5 years of New Hampshire and/or Maine Workers' Compensation Lost Time claims handling experience.
• Valid NH WC adjuster license.
• Excellent organizational skills with the ability to handle multiple tasks and effectively prioritize workload.
• Demonstrated depth in negotiation and claims resolution skills.
• Strong computer skills and ability to work with multi-faceted systems.
• Ability to effectively and independently manage a complex workload while exhibiting very sound judgment.
• Excellent written and verbal communication skills.
• Demonstrated ability to develop and maintain relationships with agents and other departments while exemplifying superior teamwork.
• Advanced professional insurance coursework (i.e., AIC, CPCU) or completion of other insurance-related classes is preferred.
• Valid Driver's License is required.
Education Requirement
• Bachelor's degree (B.A.) and a minimum of 5 years of related experience and/or training, or an equivalent combination of education and experience.
Additional Company Details
We do not accept unsolicited resumes from third party recruiting agencies or firms.
The company offers a competitive compensation plan and robust benefits package for full time regular employees including:
• Base Salary Range: 90k-$105k
• Eligible to participate in annual discretionary bonus
• Benefits include: Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit-sharing plans
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
