Complex Claims Specialist - Workers' Compensati...

Berkshire Hathaway Direct Insurance Company (BHDIC) is the home of commercial small business insurance products biBerk Business Insurance and THREE by Berkshire Hathaway. Our Claims Department is looking for an experienced claims specialist with a strong background in complex Workers’ Compensation claims. This role handles a caseload of highly complex/high-severity Workers’ Compensation claims and requires a comprehensive knowledge of Workers’ compensation regulations, laws, and best practices. This role will report to the Workers’ Compensation Complex Claims Team Lead. Multi-state experience handling Workers’ Compensation claims in the following jurisdictions is preferred: California, Arizona, Colorado, Wyoming, Texas, Oklahoma. Location: This is a full-time remote position. This position may require occasional travel to attend mediations, trainings, and/or other related department meetings. Job Responsibilities The Complex Claims Specialist will be responsible for, but not limited to: Investigate coverage, determine compensability, and manage a pending of high exposure Workers’ Compensation claims involving catastophic injuries and complex cases Proactively establish and update reserves throughout the life of the claim to reflect claim exposure and document supporting rationale Resolve claims within authority and make independent case value recommendations to senior leadership on cases which exceed authority Participate in reserving, pricing and strategy discussions with senior leadership Collaborate with outside defense counsel to effectively manage litigated files according to established litigation management guidelines 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 policyholders, agents, injured workers, medical providers, legal, and vendors Follow escalation and reporting requirements on claims with significant exposure Develop creative resolution strategies to manage losses involving complex issues, effectively utilizing appropriate internal and external resources Document claim files in accordance with company and regulatory guidelines Identify subrogation potential and red flags that require SIU involvement Train new team members Act as a technical resource to less experienced claims representatives Maintain continuing education requirements Qualifications Knowledge and Experience: Active adjuster license required 10+ years of experience handling complex workers’ compensation claims Excellent organizational, leadership, communication and time management skills Experience with structured settlements and Medicare Set-Asides 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 Advanced verbal and written communication skills are essential for interacting with internal and external stakeholders Education: BA/BS degree required AIC, SCLA, CPCU or other industry designation a plus About Us 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 Subsidized downtown parking (for in-office positions) 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 Service recognition after 5 years of employment In accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided. The salary range for this position is $100,000 - $125,000 per year. Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law.