Senior Workers' Claims Representative; Northeast

All Jobs >
Senior Workers' Compensation Claims Representative (Northeast)

Senior Workers' Compensation Claims Representative (Northeast)
Fully Remote
• United States
• BHDIC Claims

Full-time

Berkshire Hathaway Direct Insurance Company (BHDIC) is the home of commercial small business insurance products biBerk Business Insurance and THREE by Berkshire Hathaway. Our Claims Department is seeking an experienced Workers’ Compensation claims professional who combines strong technical claim handling and litigation management expertise with a passion for developing others. In addition to managing a caseload, this role serves as a key technical resource, providing mentorship, training, and guidance to a claims team, including direction on litigated claims.

This position reports to a Workers’ Compensation Claims Team Lead.

Location:

This is a full-time remote position. This position may require occasional travel to attend mediations, trainings, and/or other related department meetings.

The Senior Claims Representative will be responsible for, but not limited to:

• Investigate coverage, determine compensability, and manage a pending of Workers’ Compensation claims in multiple jurisdictions
• Proactively establish and update reserves throughout the life of the claim to reflect claim exposure and document supporting rationale
• Resolve claims within authority and make independent case value recommendations to senior leadership on cases which exceed authority
• Participate in reserving, pricing and strategy discussions with leadership
• Collaborate with outside defense counsel to effectively manage litigated files according to established litigation management guidelines
• Partner with medical providers, customers, and injured workers to facilitate appropriate medical treatment and ensure timely submission of medical bills
• Ensure compliance with state and federal Workers’ Compensation regulations
• Provide exceptional customer service to policyholders, agents, injured workers, medical providers, legal, and vendors
• Document claim files in accordance with company and regulatory guidelines
• Identify subrogation potential and red flags that require SIU involvement
• Serve as a mentor to new and developing team members by providing ongoing coaching, technical guidance, and assisting with escalated issues
• Lead onboarding and training activities for newly hired claims representatives
• Partner with leadership to identify training opportunities, develop educational materials, and support continuous improvement initiatives within the Workers’ Compensation claims department
• Serve as a senior technical resource and mentor to less experienced claims representatives by providing guidance on complex claim issues, strategic decision-making, reserving, litigation management, and settlement evaluations.
• Maintain continuing education requirements
• Performs other duties as assigned

• 7+ years of experience handling litigated workers’ compensation claims
• Excellent organizational and leadership skills
• Experience with structured settlements and Medicare Set-Asides
• Ability to work in a fast-paced, collaborative, virtual office environment
• Strong analytical, organizational, and time management skills
• Excellent written and verbal communication skills
• Ability to work independently and meet assigned deadlines
• Ability to multi-task and effectively prioritize tasks with frequent interruptions
• Proficiency with MS Word, Excel and internet applications
• Highly attentive to details
• Able to work under pressure and execute good judgment in sensitive situations
• Advanced verbal and written communication skills
• Demonstrated experience training, mentoring, or coaching claims professionals in a Workers’ Compensation environment