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
- At Selective, we maintain a commitment to provide unique insurance solutions that help keep the families and businesses of our communities protected. It was founded in 1926, and is headquartered in Branchville, New Jersey, USA, with a workforce of 1001-5000 employees. Its website is https://www.selective.com/.