Workers' Compensation Claim Representative I (Early Talent) - Eastern Alliance

About the role

ProAssurance is a leading specialty insurer specializing in healthcare professional liability, products liability for medical technology and life sciences, legal professional liability, and workers' compensation insurance. This position supports the Workers' Compensation line of business, Eastern Alliance, and is hybrid, requiring approximately 2 visits per month to either the Charlotte NC or Ridgeland MS office.

Responsibilities

• Complete ongoing claim management activities proactively and with a sense of urgency in accordance with the ecovery® Return to Wellness philosophy to execute the established plan of action and achieve favorable outcomes for all parties.
• Maintain, cultivate, and develop high quality, collaborative working relationships with all parties, including injured workers, agents, customers, and co-workers.
• Maintain regular contact by telephone and correspondence with all parties.
• Seek complete information necessary to manage claims and achieve favorable outcomes.
• Respond to inquiries in a timely, courteous, and professional manner.
• Promptly investigate all assigned claims to establish trust and rapport with all parties, accurately assess coverage, determine the nature and extent of the injuries sustained, and reinforce Return to Wellness expectations.
• Make fair and timely determinations of compensability. Demonstrate empathy, professionalism, integrity, and objectivity at all times.
• Prepare reports and forms as required by jurisdictional regulations and by the Company’s established procedures.
• Promptly establish and maintain case reserves that accurately reflect the anticipated financial exposure on each claim; revise reserves promptly based on changes in facts and circumstances.
• Identify subrogation potential.
• Manage Return to Wellness initiatives by working collaboratively with agents, clients, risk managers and underwriters to ensure proper return to work guidelines and procedures are established, followed and achieved.
• Attend business unit, department and company meetings.
• Afford assistance with Company projects as assigned and continue professional growth and development through the attendance and participation in insurance related events/functions, seminars, classes and conferences.

Requirements

• Bachelor’s degree is preferred; a HS Diploma/GED with a minimum eight years of experience working in a medical, legal or insurance environment can replace the bachelor’s degree requirement.
• Basic knowledge of medical terminology, common medical procedures and treatments is preferred.
• Some knowledge of applicable state laws and industry standards is preferred.
• Proficiency in Microsoft Office computer applications, including Word and Excel, and ability to learn new computer software applications.
• Attention to detail in processing all information, establishing priorities and meeting deadlines.
• Excellent organization and time management skills.
• Excellent analytical and problem-solving skills, including analyzing and interpreting large amounts of information and formulating logical, objective conclusions based upon the facts.
• Able to assess the urgency and importance of a situation and take appropriate action.
• An empathic listener with the ability to listen and respond to another person in a way that engenders mutual understanding and trust.
• Able to communicate effectively and professionally both verbally and in writing with various constituencies and at all levels, both in and outside of the organization, including agency partners, customers, injured workers and providers.
• Able to maintain confidential information.
• Able to operate standard office equipment including, but not limited to copiers, printers, etc.
• Able to attend insurance and industry/business functions to promote and present a positive image of the Company.

Qualifications

• One year experience managing medical-only workers' compensation claims.

Skills

• Knowledge of applicable state laws and industry standards.
• Proficiency in Microsoft Office computer applications, including Word and Excel.
• Ability to learn new computer software applications.
• Attention to detail in processing all information, establishing priorities and meeting deadlines.
• Excellent analytical and problem-solving skills.
• Empathic listener with the ability to listen and respond to another person in a way that engenders mutual understanding and trust.
• Effective communication skills, both verbally and in writing.
• Confidentiality and ability to operate standard office equipment.

Benefits

• Best-in-class benefits program.

Pay

The salary range displayed represents the entirety of the pay grade for this position. Most candidates will start in the bottom half of the range. Factors that may be used to determine your actual salary include your specific skills, how many years of experience you have, your location and comparison to other team members already in this role.

Schedule

This position is hybrid, requiring approximately 2 visits per month to either the Charlotte NC or Ridgeland MS office.