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CNA Insurance · 7 hours ago

Workers Compensation Claims Specialist, East

Lake Mary, FL

Full-time

Onsite

Mid Level

$54K/yr - $103K/yr

4+ years exp

CNA Insurance is committed to creating a supportive culture for its employees. The Workers Compensation Claims Specialist will manage commercial claims with moderate to high complexity, ensuring adherence to company protocols while providing exceptional customer service and maintaining compliance with regulatory requirements.

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Responsibilities

Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits

Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information

Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters, estimating potential claim valuation, and following company's claim handling protocols

Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim

Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims

Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate

Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service

Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation

Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements

Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business

May serve as a mentor/coach to less experienced claim professionals

Qualification

Commercial insurance knowledgeClaims managementInvestigative experienceAnalytical mindsetCustomer service skillsNegotiation skillsMicrosoft Office SuiteDiversity appreciationIndependent judgementTime managementOrganizational skillsCollaboration skillsAdaptabilityCritical thinking

Required

Bachelor's Degree or equivalent experience

Typically a minimum four years of relevant experience, preferably in claim handling

Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable

Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices

Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed

Demonstrated ability to develop collaborative business relationships with internal and external work partners

Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions

Demonstrated investigative experience with an analytical mindset and critical thinking skills

Strong work ethic, with demonstrated time management and organizational skills

Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity

Developing ability to negotiate low to moderately complex settlements

Adaptable to a changing environment

Knowledge of Microsoft Office Suite and ability to learn business-related software

Demonstrated ability to value diverse opinions and ideas

Preferred

Professional designations are a plus (e.g. CPCU)

Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience

Benefits

CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals.