Workers' Compensation Claims Representative

Company Details

Acadia Insurance is a regional property casualty insurer with offices throughout the Northeast. As a member of W.R. Berkley Corporation (NYSE: WRB), one of the largest property casualty insurance holding companies in the United States, our financial strength and integrity are two of the main reasons why Independent Agents place business with us. Acadia is rated A+ (Superior) by A.M. Best, with an A+ claim paying ability rating by Standard & Poor's.

At Acadia, we value our employees, our customers, and our communities. Employees at Acadia are part of a progressive company where everyone can make a difference. We promote an inclusive environment which encourages continuous learning and the chance to grow and develop.

The Company is an equal employment opportunity employer.

Responsibilities

The Workers' Compensation Claims Representative will investigate, evaluate, and resolve assigned claims in accordance with company standards, procedures, and state regulatory requirements. The ideal candidate will have a minimum of 3-5 years of experience in adjusting Workers' Compensation claims, with a proven record of increasing responsibility, appropriate claim outcomes and excellent customer service, along with demonstrated ability to:

Key functions will include but are limited to:

• Investigate, evaluate, and resolve claims in accordance with company standards, procedures, and state regulatory requirements.

• Analyze and determine specific facts of loss to reach appropriate decisions and effectively communicate the company's compensability decisions.

• Compose a variety of other written communications to insureds, claimants, attorneys, and agents in a professional and error-free manner.

• Conduct detailed, comprehensive claim investigations including possible on-site scene examinations and in-person witness interviews when appropriate and necessary.

• Evaluate and document exposure to ensure accurate and timely reserves; immediately escalate to management cases with significant exposure.

• Negotiate effectively and in good faith to achieve fair and accurate claim settlements.

• Proactively manage litigated claim files from inception to closure, including collaboration with defense counsel to determine and execute an appropriate plan of action; bring litigated cases to resolution either by negotiated settlement or hearing decisions, as appropriate.

• Retain vendors to achieve appropriate claim outcomes while remaining mindful of loss adjustment expenses.Manage assigned workloads effectively to achieve quality and quantity production goals while providing superior customer service.

• Effectively present cases in roundtable discussions with peers and members of management at all levels.Appropriately and clearly document all notes and file activity in a paperless claim system; compose detailed periodic reports including claim summary reports and large loss notifications.Communicate with other departments regarding developments on specific claim files as well as overall claim trends relevant to Acadia's business.

• Maintain a strong relationship and frequent communication with Acadia's agency partners.

• Work proficiently with various computer programs including MS Word, Excel, and other applications used in the claim handling process.

• Attend internal and external seminars and other training events and provide feedback to peers and/or members of management.

• Obtain all required state adjuster licenses and maintain them as needed by complying with continuing education requirements.

• Pursuit of industry-related professional designations is encouraged.

Qualifications

• Bachelor's degree and minimum of 3-5 years of related experience and/or training; or equivalent combination of education and experience.

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.

• Ability to write reports, business correspondence, and procedure manuals.

• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.

• Ability to apply concepts of basic algebra and geometry. Ability to define problems, collect data, establish facts, and draw valid conclusions.

• Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

• Valid Driver's License required and Adjuster's license where required.

Additional Company Details

We do not accept unsolicited resumes from third party recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees.

Sponsorship Details

Sponsorship not Offered for this Role Responsibilities The Workers' Compensation Claims Representative will investigate, evaluate, and resolve assigned claims in accordance with company standards, procedures, and state regulatory requirements. The ideal candidate will have a minimum of 3-5 years of experience in adjusting Workers' Compensation claims, with a proven record of increasing responsibility, appropriate claim outcomes and excellent customer service, along with demonstrated ability to: Key functions will include but are limited to: - Investigate, evaluate, and resolve claims in accordance with company standards, procedures, and state regulatory requirements.

• Analyze and determine specific facts of loss to reach appropriate decisions and effectively communicate the company's compensability decisions.

• Compose a variety of other written communications to insureds, claimants, attorneys, and agents in a professional and error-free manner.

• Conduct detailed, comprehensive claim investigations including possible on-site scene examinations and in-person witness interviews when appropriate and necessary.

• Evaluate and document exposure to ensure accurate and timely reserves; immediately escalate to management cases with significant exposure.

• Negotiate effectively and in good faith to achieve fair and accurate claim settlements.

• Proactively manage litigated claim files from inception to closure, including collaboration with defense counsel to determine and execute an appropriate plan of action; bring litigated cases to resolution either by negotiated settlement or hearing decisions, as appropriate.

• Retain vendors to achieve appropriate claim outcomes while remaining mindful of loss adjustment expenses.Manage assigned workloads effectively to achieve quality and quantity production goals while providing superior customer service.

• Effectively present cases in roundtable discussions with peers and members of management at all levels.Appropriately and clearly document all notes and file activity in a paperless claim system; compose detailed periodic reports including claim summary reports and large loss notifications.Communicate with other departments regarding developments on specific claim files as well as overall claim trends relevant to Acadia's business.

• Maintain a strong relationship and frequent communication with Acadia's agency partners.

• Work proficiently with various computer programs including MS Word, Excel, and other applications used in the claim handling process.

• Attend internal and external seminars and other training events and provide feedback to peers and/or members of management.

• Obtain all required state adjuster licenses and maintain them as needed by complying with continuing education requirements.

• Pursuit of industry-related professional designations is encouraged.