Workers: SR. WORKERS COMP CLAIMS REP (HYBRID/REMOTE)
Charlotte, NC 28277
PROFILE INSIGHTS
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SKILLS AND JOB DETAILS
Job type : full time
Benefits
Pulled from the full job description
- Employee discount
- Employee stock purchase plan
- Health insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
FULL JOB DESCRIPTION
At selective, we don’t just insure uniquely, we employ uniqueness.
OUR BUSINESS
Selective is a midsized U.S. domestic property and casually insurance company with a history of strong, consistent financial performance for nearly 100 years. Selective’s unique position as both a leading insurance group and an employer of choice is recognized in a wide variety of awards and honors, including listing in forbes Best Midsize Employers in 2024 and certification as a Great Place Work in 2024 for the 5th consecutive year.
WORKING AT SELECTIVE
At selective, we don’t just insure uniquely-we employ uniqueness. Employees are empowered and encouraged to be uniquely you be by being their true, unique selves and contributing their diverse talents, experiences, and perspectives to our shared success. Together, we are a high-performing team working to serve our costumers responsibly by helping to mitigate loss, keep them safe and restore their lives and businesses after an insured loss occurs.
Selective insurance offers a total rewards package that includes a competitive base salary, incentive plan eligibility at all levels, and a wide array of benefits designed to help you and your family stay healthy, achieve your financial goals, and balance the demands of your work and personal life.
These benefits include comprehensive health care plans retirement saving plan with company match, discounted employee stock purchase program, tuition assistance and reimbursement programs and paid time off plans. Additional details about our total rewards package will provided during the recruiting process.
Click to learn more about the selective a Sr Workers comp claims culture and why selective is right for you!! https://youtu.be/zuF1YgAyQfo
Selective insurance is seeking a sr. Workers comp claims rep dor our charlotte, NC office. We will also consider remote for the ideal candidate if they reside outside of NC and SC.
This position will be responsible for investigating lost-time claims to determine coverage and compensability based on jurisdictional guidelines. Obtain revelant information necessary for thorough investigation, be able to freeze facts of claims and make timely decisions. Effective and consistent partnership with nurse management to return injured worker back to gainful employment when necessary.
Manage litigation of cases in collaboration with staff and panel counsel. Manage administration of benefits and claim resolution. Provide compelling customer service.
Responsibility includes effective and timely communication with employer, employee, and medical provider.
JOB RESPONSIBILITIES
- Receives assigned lost-time claims for investigation to determine coverage and compensability on claims with a disability period greater than 10 weeks.
- Processes claims which include the following activities : Making contacts, setting reserves, establishing file in MCS, evaluating exposure and establishing initial and subsequent reserves on claims with an exposure greater than $25,000, and analyzing investigational data. Make timely payments and follows through to resolution.
- Handles both non-litigated and litigated cases.
- Collaborates with nurses and vendors on medical and disability management. Collaborates with staff counsel or panel counsel on litigated cases.
- Documents claims files and maintains control of work through documentation or dairy system.
- Handles disputed facts, benefits, compensability, coverage, medical causality and relatedness.
- File state forms timely, in accordance with statutory guidelines.
- Prepare for and participate in claims review and settlement conferences.
- Ensures compliance with company, state and federal regulations.
JOB QUALIFICATIONS :
- College degree preferred
- 3–5 years claims experience preferred.
- Experience in New Jersey workers compensation
- Knowledge of workers compensation statutes coverage and case law.
- Excellent written and verbal communication skills.
- Working knowledge of medical treatment and terms as relate to medical only workers compensation claims.
- Critical thinking skills to assess compensability of WC claim as it relates to the facts and law.
The expected starting salary range for this is $62,000 – $98,000. The actual base salary is based on geographic location, and the range is representative of salaries for this role throughout selective’s footprint. Additional considerations include revelant education, qualifications, experience, skills, performance, and business needs.
Selective insurance is an equal employment opportunity employer, that means we respect and value every individual’s unique opinions, beliefs, abilities, and perspectives, we are committed to promoting a welcoming culture that celebrate divers talent, individual identity, different points of view and experiences- and empowers employees to contribute new ideas that support our continued and growing success.
Building a highly engaged team is one of our core strategic imperatives, which we believe is enhanced by diversity , equity, and inclusion. We expect and encourage all employees and all of our business partners to embrace, practice, and monitor the attitudes, values, and goals of acceptance, address biases , and faster diversity of viewpoints and opinions.
selective insurance maintains a drug-free workplace.
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