Claims Specialist (Workers Compensation)

Job Information Job Title Claims Specialist (Workers’ Compensation) Home Department: Claims Employment Status: Non-Exempt; Full-time Schedule: 40 hours/week with Flexible Scheduling Opportunities Position Location: Home Office, Hybrid, and Remote Opportunities in: CO, GA, IL, IN, IA, MN, TN, TX, & WI Overview Protecting our policyholders’ dreams, passions, and livelihoods has a direct impact on the communities we serve. We work towards excellence, conduct ourselves with high integrity, and take our work seriously, but not ourselves. Small Details. Big Difference. Find out how you can make a difference with a career at Society. Society Insurance is seeking an entry-level Claims Specialist to join our Workers’ Compensation team. With manager guidance and structured training, the Claims Specialist will learn to investigate and resolve mild to moderate complex claims that may have limited period of indemnity; and will monitor ongoing permanency/death claims in accordance to claims handling practices. About the Role Handles and settles mild to moderate complex claims that may have limited period of indemnity; monitors ongoing permanency/death claims; reaching agreement with claimant according to policy provisions and authority level; and handling subrogation within authority level. Resolves questionable claims by investigating and comparing claims information with evidence. Identifies files involving potential investigation with manager guidance by analyzing documentation and records, evaluating evidence, and referring files to appropriate staff. Determines insurance coverage by examining claim forms, policies, and other records; interviewing claimants, insureds, and witnesses; reviewing police and hospital records; and consulting with experts. Promotes early return to work by communicating and coordinating between involved parties. Keeps current with claims through follow-up discussions with injured workers and insureds; and makes recommendations regarding future handling of files based on claim facts. Ensures accurate file documentation by complying with claims handling guidelines and state requirements. Ensures company guidelines and procedures are followed by overseeing independent adjusters during investigations and attorneys in the handling of discovery and settlement. Develops and maintains professional, technical knowledge and expertise in a specified line(s) of business through training courses and continuing education coursework. Contributes to team effort by participating in determining department investigation guidelines; providing feedback to underwriting as needed. About Yo u You enjoy communicating and building relationships with others. You are composed, cool under pressure, and can negotiate without damaging relationships. You hold yourself accountable and act in accordance with rules and regulations. You enjoy analyzing, investigating, and using the facts to make decisions. You are naturally curious and have a desire to know more. You apply an investigative approach to identifying facts and evaluating evidence. What it Will Take Bachelor’s Degree in business or related field OR 1+ years of claims handling experience involving the exercise of discretionary decision-making as determined by Society Insurance OR 3+ years of knowledge in the property & casualty insurance industry Familiarity with PC applications including word processing, Internet, spreadsheets, and e-mail software. Ability to obtain and maintain proper licensing prior to handling a state that requires it. Valid driver’s license and a satisfactory driving record as determined by Society Insurance. Prior workers’ compensation indemnity experience highly desirable. Professional insurance designations highly desirable. What Society Can Offer Comprehensive Benefits Package: Salary with bonus plan; health, dental, life, and vision insurance Retirement: Traditional or Roth 401(k) Defined Contribution Plan PLUS Profit-Sharing Plan Work-Life Balance: Company-paid holidays; flexible scheduling; PTO; telecommuting options Education: Career Coaching; company-paid courses; student loan and tuition reimbursement Community: Charitable Match; paid volunteer time; team sponsorships Wellness: Employee Assistance Program; wellness initiatives/rewards; health coaching; and more Society Insurance prohibits discrimination and harassment of any type against applicants and employees on the basis of race, color, religion, sex, national origin, age, handicap, disability, genetics, veteran status or military service, marital status or sexual orientation, gender identity or expression, or any other characteristic or status protected by federal, state or local laws. Society Insurance also provides reasonable accommodations to qualified individuals with disabilities in accordance with the requirements of the Americans with Disabilities Act and applicable state and local laws. Society Insurance is a drug-free workplace.