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.
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.
Absorb and assist 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
The ideal candidate will have one year experience managing medical-only workers' compensation claims. 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 is required. Attention to detail in processing all information, establishing priorities and meeting deadlines is essential. Excellent organization and time management skills are necessary. Excellent analytical and problem-solving skills, including analyzing and interpreting large amounts of information and formulating logical, objective conclusions based upon the facts are required. Ability to assess the urgency and importance of a situation and take appropriate action is necessary. Empathic listener with the ability to listen and respond to another person in a way that engenders mutual understanding and trust is required. Ability 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 is required. Ability to maintain confidential information is necessary. Ability to operate standard office equipment including, but not limited to copiers, printers, etc. is required. Ability to attend insurance and industry/business functions to promote and present a positive image of the Company is required.
Qualifications
- 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.
Skills
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 is required. Attention to detail in processing all information, establishing priorities and meeting deadlines is essential. Excellent organization and time management skills are necessary. Excellent analytical and problem-solving skills, including analyzing and interpreting large amounts of information and formulating logical, objective conclusions based upon the facts are required. Ability to assess the urgency and importance of a situation and take appropriate action is necessary. Empathic listener with the ability to listen and respond to another person in a way that engenders mutual understanding and trust is required. Ability 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 is required. Ability to maintain confidential information is necessary. Ability to operate standard office equipment including, but not limited to copiers, printers, etc. is required. Ability to attend insurance and industry/business functions to promote and present a positive image of the Company is required.
Benefits
We are committed to providing a dynamic and inclusive environment where everyone can do their best work and grow personally and professionally. For that reason, we partner with The Predictive Index (PI) – an organization equally committed to improving the working lives of people, to help us hire the best talent by providing additional insight about one’s work style. The position you applied to requires completion of two assessments prior to being scheduled to interview with a hiring manager. A Talent Acquisition team member may review your application and contact you before the assessment is complete. These assessments are Behavioral and Cognitive, and each assessment takes less than 12 minutes to complete. After submitting your application, you will receive two emails from The Predictive Index inviting you to complete each of these assessments (please check your SPAM or Junk email folder if you do not see these emails in your inbox). Note: If you already completed the assessments as part of an application with us, we may have results on file and you may not receive the emails inviting you to take the assessments. If you are moving forward in the process, a Talent Acquisition team member will confirm if we already have your assessment results.
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.