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Claims Examiner – Trainee
Berkshire Hathaway Homestate Companies - Workers Compensation DivisionClaims Adjuster managing a caseload of workers compensation claims from inception to resolution. Part of a dynamic and growing organization with training and career growth opportunities.
About the role
Key responsibilities & impact- Completes classroom training introducing workers’ compensation claims handling strategies, medical terminology, and legal concepts.
- Learns skills such as investigative and persuasive communication, negotiation, decision-making, and strategic planning. Learns to review and interpret medical records.
- Conducts and directs the investigation of reported claims to determine coverage, compensability and severity and to gather all other relevant information, including making three-point contact telephone calls.
- Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
- Develops and updates a plan of action for the successful resolution of each claim.
- Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently.
- Reduces fraud through early identification and escalation.
- Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.
- Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims.
- Ensures that the actions of all other professionals involved in managing a claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim.
Requirements
What you’ll need- Minimum of High School Diploma or equivalent certificate required; Bachelor’s degree from four-year college or university is preferred
- Ability to communicate effectively verbally and in writing; Spanish Fluency ability preferred
- Exceptional interpersonal and customer service skills
- Ability to manage and prioritize multiple assignments in a fast-paced environment
- Strong organization skills to ensure tasks are completed within hard deadlines
- Basic mathematical skills to calculate monetary reserves
- Knowledge of Microsoft Word, Powerpoint, Excel, Outlook
Benefits
Comp & perks- Unparalleled financial strength and stability
- Fantastic growth and advancement opportunities
- WFH Hybrid schedule
- Free gym in building
- Generous Paid Time Off and Holidays
- Excellent Benefits (Medical, Dental, Vision, 401k, etc)
- Health and Wellness Reimbursement
- Tuition Assistance Reimbursement
- Discounts across companies such as GEICO, See’s Candies, etc.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medical TerminologyLegal ConceptsCalculating ReservesReviewing Medical RecordsDecision-MakingStrategic PlanningFraud IdentificationTask Assignment
Soft Skills
Effective CommunicationInterpersonal SkillsCustomer ServiceOrganization SkillsTime Management