Workers Compensation Claims Examiner

Company Details

 

 

At Berkley Entertainment, we have over 25 years of underwriting risks in Entertainment & Sports.  Our one focus is entertainment insurance. We bring our decades of entertainment experience together to go beyond the basics, providing crafted coverage solutions to protect our clients.

 

Our team’s industry experience and collaborative approach leads to great client solutions — and this is by design. We are here to assist with customizing products and services that are tailored to respond to each client’s unique exposures.

Responsibilities

Berkley Entertainment is seeking a Workers Compensation claims handler.  This position is located in our Irving, TX headquarters on a hybrid basis.

 

The position requires the ability to multitask, and candidates should have strong organizational and interpersonal communication abilities. The claims examiner reviews, evaluates and processes workers compensation medical only claims of moderate to severe complexity or severity in multiple jurisdictions.

 

•  Responsible for the day to day management of moderate to severe complexity or severity medical only claims in multiple state jurisdictions. 
• Investigates new claims to determine compensability and proactively follows up to determine the need for any Lost Time adjuster involvement.
• Is responsible for determining and satisfying jurisdictional reporting requirements.
• Ensure the claim is adequately reserved.  Will review and pay medical and expense bills timely and accurately, and will evaluate each claim for subrogation potential.
• Act as a mentor to the Medical Only examiners, assisting in preparing them for the next step in career progression.
• Read and interpret surgical reports and notes.
• Occasionally review requests from surgeons for payments above the normal fee schedule.

Qualifications

• Bachelor’s degree in business, insurance or related field preferred.
• 3+ years of prior Medical Only claims handling experience required.
• Demonstrates strong written and verbal communication skills.
• Ability to draft communications that are clear, concise, complete and professional.
• Demonstrates strong time management and organizational skills.
• Must have a TX Adjuster’s License.
• Proficient in Microsoft Suite applications.  Working knowledge of Excel, Word, and general computer skills.

Additional Company Details

The Company is an equal employment opportunity employer. We do not accept any unsolicited resumes from external recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.

Sponsorship Details

Sponsorship not Offered for this Role

Responsibilities

Berkley Entertainment is seeking a Workers Compensation claims handler.  This position is located in our Irving, TX headquarters on a hybrid basis.
 
The position requires the ability to multitask, and candidates should have strong organizational and interpersonal communication abilities. The claims examiner reviews, evaluates and processes workers compensation medical only claims of moderate to severe complexity or severity in multiple jurisdictions.
 
-  Responsible for the day to day management of moderate to severe complexity or severity medical only claims in multiple state jurisdictions. 
- Investigates new claims to determine compensability and proactively follows up to determine the need for any Lost Time adjuster involvement.
- Is responsible for determining and satisfying jurisdictional reporting requirements.
- Ensure the claim is adequately reserved.  Will review and pay medical and expense bills timely and accurately, and will evaluate each claim for subrogation potential.
- Act as a mentor to the Medical Only examiners, assisting in preparing them for the next step in career progression.
- Read and interpret surgical reports and notes.
- Occasionally review requests from surgeons for payments above the normal fee schedule.