Senior Claims Specialist, Workers Compensation
Zurich Insurance
Workers Compensation Claims Adjuster
Berkshire Hathaway GUARD Insurance Companies
full-time
Posted on:
Location Type: Hybrid
Location: Wilkes Barre • Pennsylvania • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Manage all aspects of stable claims, including: Monitoring and processing ongoing benefits.
- Reviewing and paying reasonable, necessary, and related medical bills.
- Denying unrelated or unnecessary medical expenses.
- Conducting mandatory reserve reviews and adjusting reserves as needed.
- Filing reinsurance reports as required.
- Resolving system alerts and maintaining claim documentation.
- Updating claim status and plan of action (POA) tabs periodically.
- Working toward claim resolution when appropriate.
- Reassigning claims to the Complex Claims Unit (CCU) if they no longer meet stability criteria.
Requirements
- Proven experience in workers compensation claims adjusting.
- Ability to manage a large caseload efficiently and accurately.
- Strong analytical and decision-making skills.
- Excellent communication and organizational abilities.
- Required state licenses and continuing education credits (must be obtained and maintained).
Benefits
- Competitive compensation
- Healthcare benefits package that begins on first day of employment
- 401K retirement plan with company match
- Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
- Up to 6 weeks of parental and bonding leave
- Hybrid work schedule (3 days in the office, 2 days from home)
- Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
- Tuition reimbursement after 6 months of employment
- Numerous opportunities for continued training and career advancement
- And much more!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims adjustingmedical bill reviewreserve reviewsreinsurance reportingclaim documentationclaim resolutioncaseload managementanalytical skillsdecision-making
Soft skills
communicationorganizational abilities
Certifications
state licensescontinuing education credits
