Claims Specialist III - Workers Compensation

Broadspire, a fast growing company with over 2,000 employees nationally, offers a broad array of customized casualty claims, medical management and integrated disability management services designed to increase employee productivity and contain costs. The services Broadspire offers include workers' compensation, auto and general liability claims management; medical and field care management, either integrated with casualty services or available on an unbundled basis; integrated workers' compensation and disability management programs; and risk and safety consulting.

Investigate and settle moderate-to-difficult claims for assigned lines of business promptly and equitably under general supervision. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Sets reserves and recommends reserve changes to supervisor and Company attorneys in preparing cases for litigation.

ESSENTIAL DUTIES/RESPONSIBILITIES:

1. Receives claim assignment, confirms policy coverages and directs acknowledgement of claims.

2. Interprets and makes decisions using independent judgment on moderate-to-difficult claims and policy coverages and determines if coverage applies to claims submitted.

3. Investigates claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required.

4. Analyzes claims activity and prepares reports for clients/carriers and management.

5. Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.

6. Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits.

7. Develops subrogation and third party recovery potential and follows reclaim procedures.

8. Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews.

Bachelor?s degree or equivalent experience required. Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU)

Technical claims investigations/settling experience with 3-6 years experience in Broadspire Claims or similar organization.

Ability to work independently while assimilating various technical subjects..

Good verbal and written communication skills.

Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.

Strong ability to identify, analyze and solve problems.

Effective interpersonal skills to effectively interact with all levels of internal and external clients.

Broadspire offers excellent benefits, training, and competitive salaries. If you are interested in joining a leader in the third party claims administration industry, please apply now.
EOE
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