Worker's Compensation Claim Specialist

Hastings Mutual Insurance Co Hastings , MI 49058

Posted 6 days ago

Hastings Mutual is currently looking for a Worker's Compensation Claim Specialist. The individual in this role will investigate, evaluate, and resolve moderate to complex claims within the company's contractual and legal obligations while providing quality service and ensuring appropriate payments to our customers.

Reporting to the Worker's Compensation Claim Supervisor, this position can either be remote based (work from home) or at our Hastings, Michigan corporate headquarters.

Position Duties & Responsibilities

  • Responsible for the review of assigned open and closed worker's compensation claims to ensure they are handled according to Company policies and procedures, resulting in an equitable resolution within the Company's contractual and legal liability.

  • Uses Hastings Mutual's claims systems, authorized software, estimating systems and other approved technology to perform job duties.

  • Facilitates the claim process and resolve claims in a timely manner by initiating and maintaining positive and productive communications with all customers. This may include meeting with agents and large accounts to do onsite presentations.

  • Appropriately reviews and applies coverage for all claims, and provides assistance to others in the claim department regarding coverage issues, reserves, exposure, settlement value, and strategy when appropriate.

  • Investigates, evaluates and settles claims within the scope of the company's contractual and legal obligations to ensure that settlements are fair and equitable to the insured, claimant, and the company.

  • Ensures that salvage and subrogation opportunities are identified and pursued in order to minimize claim losses and improve company results.

  • Utilizes all appropriate loss and expense savings programs and direct the activities of outside vendors to ensure that only necessary and cost-effective work is accomplished.

  • Documents all claim files accurately and thoroughly to substantiate the disposition of the claim and minimize the possibility of erroneous payments. Properly utilize and document all files in the claim system of record.

  • Establishes and maintains appropriate case reserves in an amount sufficient to fund the payment of the claim once it is resolved, whether through settlement, litigation or arbitration as soon as it can be practically done.

  • Identifies potential fraud and refer to appropriate authority. Interaction and contact will occur with surveillance companies, independent adjusters, and special investigators.

  • Coordinates relevant claim information with Loss Control, Underwriting, Marketing, etc., to maximize the company's effectiveness in avoiding future losses and to better manage the current business.

  • May also participate in special projects, committees or assignments from the supervisor or manager and serve as a technical resource for other adjusters. The incumbent may assist in departmental training.

  • Leads field investigations as warranted or permitted in large claims, construction accident, serious or certain other losses, particularly where the insured's action(s) may be implicated or have contributed to the loss.

  • Might be deployed to a remote location to assist with catastrophe-related claims.

Candidate Requirements & Qualifications

  • Bachelor's degree preferred. May consider formal insurance education and equivalent claim work experience.

  • At least ten years of increasing experience, with at least five in worker's compensation claims required.

  • Jurisdictional experience in Michigan, Illinois, Indiana, Wisconsin, and/or Iowa preferred.

  • A minimum of three years working with files in litigation.

  • Professional designations: Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriter (CPCU) or be actively working towards a designation.

  • Excellent demonstrated verbal and written communication ability with experience presenting and facilitating training.

  • Demonstrated ability to prioritize multiple duties and embody a results-focused orientation.

  • Demonstrated ability to provide excellent customer service to agents, policyholders and internal/external stakeholders.

  • High level of self- motivation with the ability to plan, organize, and complete tasks independently without close supervision.

  • Ability to exemplify Hastings Mutual behavior standards and comply with all ethical guidelines.

About Hastings Mutual

From our humble roots in 1885 providing coverage for windstorm damage, Hastings Mutual has evolved into a leading regional property and casualty insurance carrier, offering innovative products for businesses, farm owners, and individuals. We work with customers in six Midwestern states (Illinois, Indiana, Iowa, Michigan, Ohio, and Wisconsin). Hastings Mutual is known for its financial strength, high ethical standards, and a culture of service and responsiveness.

Core to our ongoing success is our employees. Whether at the corporate offices in Hastings, Michigan, information technology office in Alpharetta, Georgia to our remote team members throughout the Midwest, Hastings Mutual is made up of talented professionals across multiple divisions and functional areas. Our commitment to our employees and work culture has been confirmed with our inclusion in the "Best and Brightest Companies to Work for in West Michigan" each year since 2011.

Hastings Mutual offers a friendly, family-like environment that values transparency and approachability. We recognize the hard work of our employees with many benefits, including fully paid certification training, a cafeteria and fitness center at our corporate offices, ongoing professional development opportunities, and financial stability backed by our "A" rating from A.M. Best. We also have a long-term commitment to the communities in which we live and work, either through partnerships with local charitable organizations or through our own Hastings Mutual Charitable Foundation.

At Hastings Mutual, we're always looking for professionals of all experience and education levels to help us continue our more than 130-year history of successful, stable growth.


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VIEW JOBS 4/12/2019 12:00:00 AM 2019-07-11T00:00 Hastings Mutual is currently looking for a Casualty Claim Specialist. The individual in this role will investigate, evaluate, and resolve will investigate, evaluate, and resolve moderate to complex commercial casualty claims within the company's contractual and legal obligations while providing quality service and ensuring timely, appropriate payments to our policyholders. Reporting to the Complex Casualty Claim Supervisor, this position will be either based at our Hastings, Michigan corporate headquarters or remote (home) based within our six-state (MI, OH, IN, IL, IA, WI) operating territory. Position Duties & Responsibilities * Responsible for the review, investigation, and settlement of assigned open and closed claims to ensure they are handled according to Company policies and procedures, resulting in an equitable resolution within the Company's contractual and legal liability. * Uses Hastings Mutual's claims/estimating system (Guidewire ClaimCenter) and other approved technology to perform job duties. * Facilitates the casualty claim process and resolves in a timely manner by initiating and maintaining positive and productive communications with all policyholders. This may include meeting with agents and large accounts to do onsite presentations. * Appropriately reviews and applies coverage for all claims, and provides assistance to others in the claim department regarding coverage issues, reserves, exposure, settlement value, and strategy when appropriate. * Ensures that salvage and subrogation opportunities are identified and pursued in order to minimize claim losses and improve company results. * Utilizes all appropriate loss and expense savings programs and directs the activities of outside vendors to ensure that only necessary and cost-effective work is accomplished. * Documents all claim files accurately and thoroughly to substantiate the disposition of the claim and minimize the possibility of erroneous payments. Properly utilize and document all files in the claim system of record. * Establishes and maintains appropriate case reserves in an amount sufficient to fund the payment of the claim once it is resolved, whether through settlement, litigation or arbitration as soon as it can be practically done. * Identifies potential fraud and refer to appropriate authority. Interaction and contact will occur with surveillance companies, independent adjusters, and special investigators. * Coordinates relevant claim information with Loss Control, Underwriting, Marketing, etc., to maximize the company's effectiveness in avoiding future losses and to better manage the current business. * May also participate in special projects, committees or assignments from the supervisor or manager and serve as a technical resource for other adjusters. The incumbent may assist in departmental training. * Leads field investigations were warranted or permitted in large claims, construction accident, serious or certain other losses, particularly where the insured's action(s) may be implicated or have contributed to the loss. * Might be deployed to a remote location to assist with catastrophe-related claims. Candidate Requirements & Qualifications * Bachelor's degree preferred. May consider formal insurance education and equivalent claim work experience. * At least ten years of increasing experience, with at least five in complex casualty/commercial claims required. * A minimum of three years working with files in litigation. * Professional designations: Senior Claim Law Associate (SCLA) or Chartered Property Casualty Underwriter (CPCU) or be actively working towards a designation. * Excellent demonstrated verbal and written communication ability with experience presenting and facilitating training. * Demonstrated ability to prioritize multiple duties and embody a results-focused orientation. * Demonstrated ability to provide excellent customer service to agents, policyholders and internal/external stakeholders. * High level of self- motivation with the ability to plan, organize, and complete tasks independently without close supervision. * Ability to exemplify Hastings Mutual behavior standards and comply with all ethical guidelines. About Hastings Mutual From our humble roots in 1885 providing coverage for windstorm damage, Hastings Mutual has evolved into a leading regional property and casualty insurance carrier, offering innovative products for businesses, farm owners, and individuals. We work with customers in six Midwestern states (Illinois, Indiana, Iowa, Michigan, Ohio, and Wisconsin). Hastings Mutual is known for its financial strength, high ethical standards, and a culture of service and responsiveness. Core to our ongoing success is our employees. Whether at the corporate offices in Hastings, Michigan, information technology office in Alpharetta, Georgia to our remote team members throughout the Midwest, Hastings Mutual is made up of talented professionals across multiple divisions and functional areas. Our commitment to our employees and work culture has been confirmed with our inclusion in the "Best and Brightest Companies to Work for in West Michigan" each year since 2011. Hastings Mutual offers a friendly, family-like environment that values transparency and approachability. We recognize the hard work of our employees with many benefits, including fully paid certification training, a cafeteria and fitness center at our corporate offices, ongoing professional development opportunities, and financial stability backed by our "A" rating from A.M. Best. We also have a long-term commitment to the communities in which we live and work, either through partnerships with local charitable organizations or through our own Hastings Mutual Charitable Foundation. At Hastings Mutual, we're always looking for professionals of all experience and education levels to help us continue our more than 130-year history of successful, stable growth. Hastings Mutual Insurance Co Hastings MI

Worker's Compensation Claim Specialist

Hastings Mutual Insurance Co