Job Description
About the position
The Workers Comp Claims Representative at Selective Insurance is responsible for managing lost-time claims, ensuring effective communication with all parties involved, and making timely decisions regarding coverage and compensability. This hybrid role allows for a combination of in-office and remote work, focusing on providing excellent customer service while adhering to regulatory guidelines.
Responsibilities
Ā Receive assigned lost-time claims for investigation to determine coverage and compensability on claims with a short disability period of 8 weeks or less.
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Ā Process claims which include making contacts, setting reserves, establishing files in MCS, evaluating exposure, and establishing initial and subsequent reserves on less severe claims.
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Ā Document claim files and maintain control of work through documentation or diary system.
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Ā Handle non-litigated claims only.
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Ā File state forms timely in accordance with statutory guidelines.
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Ā Collaborate with nurses and vendors on medical and disability management.
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Ā Prepare for and participate in claims review and settlement conferences.
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Ā Ensure compliance with company, state and federal regulations.
Requirements
Ā 1 year of experience in claims management or a related field.
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Ā Less than high school education.
Nice-to-haves
Ā Experience in the insurance industry.
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Ā Familiarity with workers' compensation claims processes.
Benefits
Ā Comprehensive health care plans.
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Ā Retirement savings plan with company match.
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Ā Discounted Employee Stock Purchase Program.
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Ā Tuition assistance and reimbursement programs.
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Ā Paid time off plans.
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