Senior Claims Specialist - California Workers Compensation; Remote

Company Details

Berkley Net is an innovative workers compensation insurance provider that does all of our business online. Our Goal? To make doing business “Ridiculously Fast. Amazingly Easy.”

• Serves as claims technical Subject Matter Expert (SME) for other claims adjusting staff in assigned jurisdictions
• Assume full-responsibility of claims related account management activities for our large clients and serve as the Claims liaison and primary point of contact and collaborate closely with Business Development and Underwriting teams to deliver and maintain a high-level service
• Identify and notify management of any unfavorable trends related to account management
• Actively work with Business Development and Underwriting teams to monitor loss ratio for assigned accounts
• Participate in client meetings for training on claims issues and assist with claims service meetings for new accounts as requested
• Effectively investigate, evaluate, mitigate and resolve a pending inventory of litigated and high exposure workers’ compensation claims within delegated authority and in accordance with performance standards
• Promptly notify claims management of high-exposure claims and assist in compliance with reinsurance reporting requirements
• Serve as primary liaison with key internal & external business partners and vendors and actively work to develop maintain, and improve the partnerships and programs
• Monitor costs and effectiveness of internal and external business partners and vendors
• Assist claims adjusters and management with the development of claims investigation and resolution action plans
• Maintain and demonstrate high-level of knowledge of the Workers Compensation Act and Rules and Regulations in assigned jurisdictions
• Serve as the Subject Matter Expert (SME) and go to person for all technical aspects of claims handling including coverage, disability benefit management, medical management, file management, litigation management, subrogation, reserving and settlement in their assigned jurisdictions
• Actively participate in the training and development of claims adjusters through mentoring and conducting training for new hires and existing staff
• Identify and address areas for coaching and training needs of claims adjusters and communicates needs with claims management and assists in development of action plans for improvement
• Coordinate relevant legal training seminars for claims staff in assigned jurisdictions
• Visibly supports the overall claims adjusting and managed care functions in assigned jurisdictions
• Assist claims management in monitoring and researching jurisdictional case law and statutory legal trends
• Communicate case and statutory law and legal trends that impact claims handling
• Demonstrate the use of tact and discretion in all communications and provides a positive contribution to the morale of the claims department
• Lead special projects as assigned by senior claims management
• Continuously strive to improve our product and business results through innovation
• Obtain and maintain adjuster license in multiple jurisdictions as required

• Minimum of 7-9 years of technical claims handling experience with a heavy emphasis on workers’ compensation claims in multiple jurisdictions
• Supervisory experience a plus, but not required
• Consistently display a high-level of ownership, drive and accountability
• Acts as an informal leader
• Excellent written, verbal, interpersonal and relationship building skills
• Exceptional time management and organization skills
• Strong insurance business acumen and leadership skills
• Ability to work independently and strategically problem solve
• Strong analytical and critical thinking skills
• Ability to diplomatically manage conflict
• Ability to develop relationships within the organization and work effectively across departments
• Strong discretion and integrity in dealing with highly confidential and sensitive information
• Display a high-degree of attention to detail

• Bachelor’s degree or equivalent work experience
• AIC, ARM, CCP or CPCU insurance designation preferred

• Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.
• Base Salary Range: $85k-$115k

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.

• Low to moderate level of travel (up to 10% - 15% of time)
• Ability to travel nationally to attend legal hearings, conferences, trainings, file reviews, audits and business partner meetings

The Company is an equal employment opportunity employer