Berkshire Hathaway Homestate Companies - Workers Compensation Division · 1 day ago
Experienced Claims Adjuster
Dallas, TX
Full-time
Hybrid
Mid Level
3+ years expBerkshire Hathaway Homestate Companies is seeking an experienced workers compensation adjuster to manage a caseload of indemnity claims from inception to resolution. The role involves investigating claims, determining compensability, administering benefits, and coordinating medical care while ensuring high service levels to insureds.
Financial ServicesInsurance
Responsibilities
Conducts the investigation of reported claims via three-point contact calls to determine coverage, compensability and severity, and to gather all other relevant information, documenting all relevant information thoroughly and escalating the investigation for further investigation when appropriate
Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines
Calculates and administers benefits in accordance with statutory requirements, including timely issuance of appropriate notices and filings
Develops and updates a Plan of Action for the successful resolution of each claim; timely updates Plan as new information is obtained
Makes prompt, sound decisions on issues that arise in claims based on the best information available, ensuring that work is performed in accordance with Company standards, training, supervisory direction, and applicable laws. Timely escalates issues/red flags to Supervisor and/or appropriate internal team
Ensures that the actions of all other professionals involved in claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim
Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently
Accurately and thoroughly prepares litigation referrals, AOE/COE investigation referrals, and MSA referrals for submission to vendor; obtains proper approval from Management
Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates settlement of claims
Fosters a positive and close working relationship with partner company staff, including the Call Center, Medical Management, Special Investigations, Client Services, Underwriting, and Claims Legal
Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers
Collaborates with Adjusting staff and relevant interdepartmental personnel on special projects focused on process efficiency
Ensures continual education requirements are met
Qualification
Required
Minimum of a High School diploma required or equivalent certificate required
Minimum of three years of indemnity adjusting experience managing large and/or complex claims and accounts within a workers' compensation carrier required
Maintains qualifying educational criteria to adjust workers' compensation claims
Inquisitive, critical thinker; agile learner with adaptive, smart time management skills
Proficient in the Microsoft Office Suite of applications and be proficient, or able to become proficient, on applicable databases, systems and vendor software programs
Preferred
Bachelor's degree from four-year College or university preferred
Self-Insured certification preferred
Benefits
Work-Life Balance
Work From Home Program (up to 2 days per week)
Reasonable caseload with in-house Medical Management support (UR, Med Bill Review, Resource Nurses); In-house Claims Assistant support
Free On-Site Parking
Paid Time Off
Paid Holidays
Retirements Savings Match
Group Health Insurance (Medical, Dental, and Vision)
Life and AD&D Insurance
Long Term Disability Insurance
Accident and Critical Illness Insurance
Flexible Savings Accounts
Paid Community Volunteer Day
Employee Assistance Program
Tuition Reimbursement Program
Employee Referral Program
Diversity, Equity and Inclusion Program
Company
Berkshire Hathaway Homestate Companies - Workers Compensation Division
Financial Strength and Integrity With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
A
Andy Linkhart
Chief Claims Officer and Chief Financial Officer
David Speights
Vice President of Analytics
Recent News
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