Claims Team Lead - Workers' Compensation (Medical Only)
The Workers’ Compensation Medical Only Claims Team Lead will lead a medical only Workers’ Compensation claims team and handle a reduced pending of medical only Workers’ Compensation claims. This position will oversee a team of claims professionals handling nationwide medical only claims and claims technicians providing administrative support to the Workers’ Compensation claims department.
Location: This is a full-time remote position. This position may require occasional travel to attend mediations, trainings, trials and/or other related department meetings.
Job Responsibilities
The Claims Team Lead- WC Medical Only will be responsible for, but not limited to:
Evaluate, reserve, and manage a reduced pending of nationwide Medical Only Workers’ Compensation claims
Partner with medical providers, customers, and injured workers to facilitate appropriate medical treatment and ensure timely submission of medical bills
Ensure compliance with state and federal Workers’ Compensation regulations
Provide exceptional customer service to injured workers, medical providers, and customers
Responsible for team performance, development, and coaching a team consisting of medical only claims professionals and claims technicians
Partner with Claims Supervisor to identify training opportunities
Assist team with escalated issues, claim strategies, coverage positions, and guide team members to the appropriate resources
Conduct bi-annual performance and development discussions with team members
Communicate regularly with internal and external stakeholders regarding claim status
Follow escalation and reporting requirements on claims with significant exposure
Conduct team Roundtables and Committees to align on reserves and settlement values
Recognize exposures and ensure reserves are adequate and timely
Conduct weekly team meetings and regular check-in discussions with individual team members
Proactively manage claim resolution, including formation and implementation of action plans
Document claim files in accordance with company and regulatory guidelines
Identify subrogation potential and red flags that require SIU involvement
Train new team members; provide ongoing coaching and support to team
Maintain adjuster licenses, as required
Qualifications
Active adjuster license
Previous Workers’ Compensation claims experience required
Minimum 3 years handling WC claims
Previous supervisory experience a plus
Ability to work in a fast-paced, collaborative, virtual office environment
Strong analytical, organizational, and time management skills
Excellent written and verbal communication skills
Ability to work independently and meet assigned deadlines
Strong negotiation skills
Ability to multi-task and effectively prioritize tasks with frequent interruptions
Proficiency with MS Word, Excel and internet applications
Highly attentive to details
Able to work under pressure and execute good judgment in sensitive situations
Strong interpersonal skills
Excellent written and verbal communication skills
Strong organizational and computer skills
Self-motivator: works independently with minimal to moderate supervision
BA/BS degree required
AIC, SCLA, CPCU or other industry designation a plus
About biBerk
biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBERK.com will be underwritten by Berkshire Hathaway Direct Insurance Company ("BHDIC"), which is an AM Best rated A++ insurer.
BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBERK are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.
Some highlights of our benefits are:
Great work environment with growth opportunity
Competitive compensation
Generous amounts of vacation and sick time
Closed on major holidays
401(k) with company match
A fantastic healthcare package
Tuition reimbursement after 6 months of employment
Apply Now
Location: This is a full-time remote position. This position may require occasional travel to attend mediations, trainings, trials and/or other related department meetings.
Job Responsibilities
The Claims Team Lead- WC Medical Only will be responsible for, but not limited to:
Evaluate, reserve, and manage a reduced pending of nationwide Medical Only Workers’ Compensation claims
Partner with medical providers, customers, and injured workers to facilitate appropriate medical treatment and ensure timely submission of medical bills
Ensure compliance with state and federal Workers’ Compensation regulations
Provide exceptional customer service to injured workers, medical providers, and customers
Responsible for team performance, development, and coaching a team consisting of medical only claims professionals and claims technicians
Partner with Claims Supervisor to identify training opportunities
Assist team with escalated issues, claim strategies, coverage positions, and guide team members to the appropriate resources
Conduct bi-annual performance and development discussions with team members
Communicate regularly with internal and external stakeholders regarding claim status
Follow escalation and reporting requirements on claims with significant exposure
Conduct team Roundtables and Committees to align on reserves and settlement values
Recognize exposures and ensure reserves are adequate and timely
Conduct weekly team meetings and regular check-in discussions with individual team members
Proactively manage claim resolution, including formation and implementation of action plans
Document claim files in accordance with company and regulatory guidelines
Identify subrogation potential and red flags that require SIU involvement
Train new team members; provide ongoing coaching and support to team
Maintain adjuster licenses, as required
Qualifications
Active adjuster license
Previous Workers’ Compensation claims experience required
Minimum 3 years handling WC claims
Previous supervisory experience a plus
Ability to work in a fast-paced, collaborative, virtual office environment
Strong analytical, organizational, and time management skills
Excellent written and verbal communication skills
Ability to work independently and meet assigned deadlines
Strong negotiation skills
Ability to multi-task and effectively prioritize tasks with frequent interruptions
Proficiency with MS Word, Excel and internet applications
Highly attentive to details
Able to work under pressure and execute good judgment in sensitive situations
Strong interpersonal skills
Excellent written and verbal communication skills
Strong organizational and computer skills
Self-motivator: works independently with minimal to moderate supervision
BA/BS degree required
AIC, SCLA, CPCU or other industry designation a plus
About biBerk
biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBERK.com will be underwritten by Berkshire Hathaway Direct Insurance Company ("BHDIC"), which is an AM Best rated A++ insurer.
BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBERK are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.
Some highlights of our benefits are:
Great work environment with growth opportunity
Competitive compensation
Generous amounts of vacation and sick time
Closed on major holidays
401(k) with company match
A fantastic healthcare package
Tuition reimbursement after 6 months of employment
Apply Now