Senior Claims Representative - Workers' Compensation

About the role

These positions investigate, evaluate, and dispose of assigned claims in a timely manner to achieve best-practice settlements within legal statutes, policy provisions, and company and/or client guidelines. Candidates may reside in any approved hiring market provided they can report to the Harrisburg, PA, Pittsburgh, PA, or Waukesha, WI office on a hybrid basis.

Reporting relationships: In Penn National Insurance, these positions report to the Team Leader or CSO Manager. Direct contact with branch underwriting and/or claims service office personnel; Home Office claims personnel; agents, insureds, claimants, medical and legal professionals, appraisers, and independent adjusters.

Responsibilities

• Initiates self-development and training to improve, maintain, or acquire skills prescribed for professional and personal growth in claims handling
• Properly identifies and pursues subrogation, contribution, and salvage opportunities to reduce or recover payment amounts
• Uses appropriate, tactful, and complete communications to ease negotiations, develop rapport, and project a positive corporate and personal image
• Handles claims involving more complex coverage and liability issues; may require attendance at civil proceedings or workers' compensation hearings
• Develops claims files from initial assignment to disposition
• Prepares claim file documentation accurately and completely to justify all actions taken and provide an effective audit trail
• Achieves best-practice settlements in the disposition of claims
• May participate as a member of a Claims Catastrophe Team
• May act as a supervisor of a Claims Catastrophe Team
• Completes actions on a timely basis, such as verifying coverages, setting or adjusting reserves, making appropriate contacts
• Collaborates with Team Leader, Manager, and Home Office to develop case strategy, move investigations forward, and dispose of claims to keep management, claimants, insureds, and other interested parties satisfied that effective efforts are being made toward settlement
• Performs other duties as assigned by reporting managers

Qualifications

Education & Credentials

• Continuing education in insurance-related courses such as IIA Certificate in General Insurance, Senior Claims Law Associate, and Associate in Claims courses and/or Workers' Compensation courses (PA 10, 11, 12, and 13) preferred
• Associate's degree in Claims and/or Senior Claims Law Associate designations preferred
• Adjuster's license or willingness to obtain one as required

Experience

• Minimum of 5 years of experience in workers' compensation claims handling

Technical & Professional Knowledge

• Good understanding of tort and state laws applicable to assigned claims, the Unfair Claims Settlement Act, and insurance policy coverages and provisions
• Good understanding of terminology applicable to assigned claims (medical, legal, automotive, construction)
• Good communication skills, both oral and written
• Good interpersonal skills
• Good negotiation skills
• Good customer service skills
• Good analysis and evaluation skills
• Good decision-making skills
• Strong sense of urgency
• Good PC skills, with emphasis on Microsoft Office products
• Good planning and organization skills
• Ability to work independently as well as a member of a team

Competencies

• Business Acumen
• Negotiation
• Results Oriented
• Time & Priority Management

Pay

Estimated hiring range: $75,000 – $103,000, determined by skill sets, experience, training, and certifications. Eligible candidates may participate in the annual incentive program.

Requirements

This position is primarily sedentary and requires occasional standing and walking throughout the office environment. Must be able to see and effectively use a computer monitor; operate a computer, keyboard, printers, and general office equipment; access and enter information accurately using automated systems; hear and communicate via telephone and/or monitoring devices with internal and external clients; present information to individuals and groups; interpret and apply concepts that may or may not be based on established guidelines; maintain acceptable attendance and adhere to scheduled work hours; hold a valid driver's license and operate a motor vehicle; travel with overnight stays required.