Claims Team Lead

About the Company

BerkleyNet is an innovative workers compensation insurance provider that does all of our business online. Our goal is to make doing business “Ridiculously Fast. Amazingly Easy.”

Responsibilities

• Administrative and technical supervision of a team of workers’ compensation claims professionals, including staff training, development, and performance management.
• Monitor claim handling activities and provide technical and jurisdictional-specific direction and feedback to ensure timely and accurate investigation and adjudication of claims.
• Supervise all technical aspects of claims, including coverage investigation, disability benefits management, medical management, file management, litigation management, subrogation, reserving, and settlement.
• Provide team with technical training and claims handling guidance.
• Review reserve and settlement amounts over the Claims Representative authority level for approval.
• Ensure claims are clearly and adequately documented, and claims data is captured and coded correctly within the claims management software system.
• Provide team support, leadership, and motivation to promote a high level of performance.
• Establish team performance goals and objectives in alignment with business plans.
• Direct team toward the achievement of established goals and objectives.
• Perform claims quality reviews in compliance with audit requirements and quality standards on a monthly and quarterly basis.
• Identify and alert senior management to claims trends or issues.
• Resolve escalated policyholder and claimant issues related to specific claims.
• Conduct regular coaching and performance feedback discussions.
• Establish performance and career development plans in collaboration with team members, management, and HR.
• Ensure claims representatives are properly licensed or certified in assigned jurisdictions.
• Partner with HR and management on engagement strategies to improve employee engagement, job satisfaction, and create a psychologically safe work environment.
• Administer all company personnel policies and address and resolve personnel matters with the support of management and HR.
• Conduct interviews of prospective claims representative candidates and provide feedback to assist senior management with hiring decisions.
• Maintain and demonstrate knowledge of the Workers’ Compensation Act, adjudication process, and regulatory compliance framework in assigned jurisdictions.
• Attend and participate in claim file reviews with senior management and defense attorneys.
• Coordinate and lead special projects or processes as assigned by senior management.
• Continuously strive to improve our product and business results through innovation.
• Obtain and maintain adjuster license in multiple jurisdictions.

Requirements

• Minimum 3 years of experience (4–5 years preferred) handling workers’ compensation claims in multiple jurisdictions.
• Supervisory experience preferred but not required.
• Exceptional leadership and motivational skills.
• Excellent written, verbal, interpersonal, and relationship-building skills.
• Excellent time management and organization skills.
• Strong analytical and critical thinking skills.
• Ability to effectively manage and develop talent.
• Ability to implement policies, procedures, and controls to measure and improve service and financial performance.
• Ability to work independently and strategically problem-solve.
• 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.
• Detail-oriented.
• Ability to quickly learn to intuitively use internal systems.

Qualifications

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

Benefits

• Health, Dental, and Vision insurance.
• Life and Disability insurance.
• Wellness programs.
• Paid Time Off.
• 401(k) and Profit-Sharing plans.

Pay

Base Salary Range: $85,000–$110,000. 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.

Additional Requirements

• Low level of domestic U.S. travel required (up to 10% of time).
• Ability to travel nationally to attend legal hearings, conferences, trainings, file reviews, and audits.