Berkshire Hathaway Homestate Companies - Workers Compensation Division ยท 2 weeks ago
Senior Claims Professional (Workers Compensation)
Omaha, NE
Full-time
Hybrid
Senior Level
5+ years expBerkshire Hathaway Homestate Companies, Workers Compensation Division, is seeking a Senior Claims Professional. This role involves managing workers' compensation claims, aiding injured workers, and ensuring effective communication and decision-making throughout the claims process.
Financial ServicesInsurance
Responsibilities
Aids injured workers achieving rapid and full medical recovery and early, safe return to work through effective, efficient and timely medical treatment and return-to-work support
Effectively communicates with injured workers and employers. Demonstrates expertise and empathy, building trust and moving the claim forward, including timely three-point contacts on all new losses
Manages claims with an outcome-based and resolution focus. Demonstrates highly effective strategic plans for future handling that are well outlined in plans of action and followed through in a timely fashion
Demonstrates effective decision-making in compensability determinations and benefit authorizations (within designated authority parameters). Proactively utilizes resources such as Medical Management, SIU, Subrogation, Recovery, and Legal to ensure accurate determinations in compensability, causal relationship, appropriate medical treatment, and to achieve favorable outcomes
Prepares and maintains timely, accurate reserves on all claims for expected future costs of medical treatment, benefits, and other elements in accordance with Claims Handling Guidelines. Ensures reserves are escalated and approved as appropriate. Ensures there is appropriate reserve documentation in the file
Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims
Reduces fraud through early identification and escalation
Effectively manages defense attorneys. Demonstrates excellence in litigation management by being prepared for hearings in a timely manner and appropriately considering exposures, settlement options, and other legal issues
Reviews and approves vocational rehabilitation plans
Effectively manages vendors and providers. Identifies need for assignment and removal of vendors and makes effective use of vendor expertise while maintaining ownership of the claim
Demonstrates expertise in technical aspects of claim management. Works with Medicare Set-Asides, Structured Settlements, and/or Part B issues
Maintains effective relationships with internal and external service partners, including participation in periodic telephonic claims reviews
Calculates and pays benefits in accordance with the law. Ensures that the claim as a whole is managed in accordance with all legal requirements including the issuance of appropriate notices and filings
Ensures continual education requirements are met
Qualification
Required
High School Diploma or equivalent certificate
A minimum of five (5) years of indemnity adjusting experience managing large and/or complex workers' compensation claims and accounts
Licensed to adjust workers' compensation claims in one or more jurisdictions
Proficient in Microsoft Office Suite applications
Able to be proficient on applicable databases, Claims systems, and vendor software programs
Preferred
Bachelor's degree from a four-year college or university
Benefits
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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