Workers Compensation - Claims Specialist

W. R. Berkley Corporation, founded in 1967, is one of the nation’s premier commercial lines property casualty insurance providers. Berkley Environmental, established in 2004, offers underwriting and account executive units in seven regions, providing a comprehensive portfolio of environmental liability coverages on both an admitted and non-admitted basis.

Responsibilities

• Review, evaluate, negotiate, and process workers’ compensation (WC) claims of moderate, severe, or catastrophic complexity; provide recommendations and strategies for resolution and litigation management as appropriate.
• Collaborate with internal and external clients, including agents, claimants, and policyholders.
• Analyze and process WC claims by investigating and gathering information to determine compensability and exposure across multiple jurisdictions.
• Calculate and assign timely and appropriate reserves on claims; monitor reserve adequacy throughout the life of the claim.
• Develop and manage claims action plans, updating as the claim progresses, to ensure appropriate and timely resolution.
• Accurately calculate and timely pay benefits in accordance with jurisdictional guidelines.
• Operate within designated authority levels and time constraints for payments and settlements.
• File appropriate forms per jurisdictional protocol within statutory limits.
• Actively manage and guide the litigation process to ensure timely and cost-effective claims resolution.
• Participate in claim reviews, which may require limited travel, and produce timely claim reports.
• Coordinate vendor referrals for additional investigation and/or litigation management.
• Use cost containment techniques, including strategic vendor partnerships, to mitigate overall claim costs.
• Manage claim recoveries, including subrogation, Second Injury Fund recoveries, and Social Security offsets.
• Collaborate frequently with all parties involved in the claim and clearly document that collaboration.
• Maintain professional internal and external client relationships.
• Execute timely and appropriate claims activities to ensure consistent delivery of quality claims services.
• Proactively manage all litigated claims by documenting the litigation plan and budget, retaining competent counsel, communicating regularly with counsel, and documenting the litigation action plan and strategy.

Requirements

• Minimum of 7–10 years of end-to-end WC claims handling experience in MA, VA, PA, MD, DC, WV, CT, or DE.
• Extensive understanding of WC statutory benefits and state regulatory requirements in multiple jurisdictions; ability to learn new jurisdictions as needed.
• Adjuster license required in area of adjusting specialty.
• Working knowledge of Excel, Word, and general computer skills.
• Bachelor’s degree preferred.

Skills

• Claims investigation and compensability analysis.
• Reserve management and claim resolution planning.
• Litigation management and vendor coordination.
• Client relationship management and collaboration.

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: $92,000–$135,000. Eligible to participate in an annual discretionary bonus. The actual salary will be determined by factors including scope, complexity, location, skills, education, training, credentials, and experience.