WC Claims Representative - Charlotte, NC (Hybrid)
Selective Insurance is a midsized U.S. domestic property and casualty insurance company with a strong history of financial performance. They are seeking two WC Claim Representatives to manage claims, communicate with various stakeholders, and ensure compliance with regulations.
Responsibilities
- Receives assigned lost time claims for investigation to determine coverage and compensability on claims with a short disability period of 8 weeks or less (could occasionally exceed 8 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 less severe claims with a general exposure of less than $25,000, and analyzing investigational data
- Makes timely payments and follow through to resolution
- May occasionally handle claims that exceed $25,000
- Documents claim files and maintains control of work through documentation or diary system
- Handle non-litigated claims only
- File state forms timely in accordance with statutory guidelines
- Collaborate with nurses and vendors on medical and disability management
- Prepare for and participate in claims review and settlement conferences
- Ensures compliance with company, state, and federal regulations
Skills
- Knowledge of workers compensation statutes, coverage, and case law
- Excellent written and verbal communication skills
- Working knowledge of medical treatment and terms as related to medical only workers compensation claims
- Critical thinking skills to assess compensability of WC claim as it relates to the facts and law
- College degree preferred
- 1-3 years of workers comp claims experience preferred
Benefits
- Comprehensive health care plans
- Retirement savings plan with company match
- Discounted Employee Stock Purchase Program
- Tuition assistance and reimbursement programs
- 20 days of paid time off
Company Overview