Senior Workers' Compensation Claims Representative

About the company

Acadia Insurance is a regional property casualty insurer with offices throughout the Northeast. As a member of W.R. Berkley Corporation (NYSE: WRB), one of the largest property casualty insurance holding companies in the United States, our financial strength and integrity are two of the main reasons why Independent Agents place business with us. Acadia is rated A+ (Superior) by A.M. Best, with an A+ claim paying ability rating by Standard & Poor’s. At Acadia, we value our employees, our customers and our communities. Employees at Acadia are part of a progressive company where everyone can make a difference. We promote an inclusive environment which encourages continuous learning and the chance to grow and develop. Company URL: https://www.acadiainsurance.com/

Responsibilities

• Investigate, evaluate and resolve assigned workers’ compensation claims in accordance with company standards, procedures, and state regulatory requirements.
• Analyze and determine specific facts of loss to reach appropriate decisions and effectively communicate the company’s compensability decisions.
• Compose a variety of written communications to insureds, claimants, attorneys and agents in a professional and error‑free manner.
• Conduct detailed, comprehensive claim investigations including possible on‑site scene examinations and in‑person witness interviews when appropriate and necessary.
• Evaluate and document exposure to ensure accurate and timely reserves; immediately escalate to management cases with significant exposure.
• Negotiate effectively and in good faith to achieve fair and accurate claim settlements.
• Proactively manage litigated claim files from inception to closure, including collaboration with defense counsel to determine and execute an appropriate plan of action; bring litigated cases to resolution either by negotiated settlement or hearing decisions, as appropriate.
• Retain vendors to achieve appropriate claim outcomes while remaining mindful of loss adjustment expenses.
• Manage assigned workloads effectively to achieve quality and quantity production goals while providing superior customer service.
• Effectively present cases in roundtable discussions with peers and members of management at all levels.
• Appropriately and clearly document all notes and file activity in a paperless claim system; compose detailed periodic reports including claim summary reports and large loss notifications.
• Communicate with other departments regarding developments on specific claim files as well as overall claim trends relevant to Acadia’s business.