Senior Claim Representative I, California Workers' Compensation experience required, REMOTE

Job Description

Must have California Workers' Compensation experience.
Must reside within the U.S. and to work PST work hours.

This position serves as a technical expert in the claim handler career path. Under limited supervision, handles claims with litigation, complex/catastrophic and/or coverage elements. Handles the most unique cases, where little precedence has been established. May handle the most complex, high touch or labor intensive customers. Serves as a department leader by developing other employees and may function as acting manager in the absence of department management.

RESPONSIBILITIES/TASKS:

Senior Claim Representative I:
?ndependently administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.
?stablishes timely and appropriate reserves based on claim profile and anticipated financial exposure.
?epresents the Company by working closely with customers, agents and brokers to resolve the most complex claim issues.
?egotiates settlements with attorneys or injured and exercises independent judgment to settle cases prior to mediation or litigation.
?anages outside vendors to ensure cost containment efforts.
?stablishes and maintains effective working relationships with all internal and external customers.
?tays abreast of changes in workers' compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.
?ctively participates in agent/client relationship management.
?entors team members.
?ay serve as department leader in the absence of management or act as manager designee.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS

EDUCATION OR EQUIVALENT EXPERIENCE:

Bachelor's degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Senior Claim Representative I:

Seven years of progressively more responsible experience in a workers' compensation claims environment that provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing the most complex workers' compensation claims. Experience handling claims in multiple jurisdictions preferred. Bilingual skills preferred.

OR

Two years of AF Group Claims Representative III experience that includes independent handling of the most complex claims and/or the most complex, high touch or labor intensive customers.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

Senior Representative I:
?bility and proficiency in the use of computers and company standard software specific to position.
?nowledge of medical and legal terminology related to the work.
?nowledge of workers' compensation laws and regulations, including jurisdictional laws.
?ffective oral and written communication skills.
?ffective customer service skills.
?bility to negotiate, build consensus and resolve conflict.
?bility to act as a representative of the Company and establish effective working relationships.
?bility to manage multiple priorities and meet established deadlines.
?ttention to detail and analytical skills.
?bility to make independent decisions.
?bility to solve highly complex problems.
?bility to train and mentor others.
?bility to lead others.

WORKING CONDITIONS:

Work is performed in an office/remote setting with no unusual hazards. Minimal travel required.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

Pay Range 'Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $77,400 and $119,580.'

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an 'at will' basis. Nothing herein is intended to create a contract.

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About the Team

CompWest Insurance Company

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