Workers' Compensation Claims Specialist
Reports to: Workers’ Compensation Lines Supervisor/Manager Turlock Workers’
Location: Turlock
Department: Workers' Compensation
FLSA Status: Non-exempt
Summary:
This position includes the complete handling of workers' compensation claims, from date of injury to file closure and assisting producers in claim management for new and existing claims. This position requires accurate and courteous service to our fellow employees, clients, producers and company personnel. Each workers' comp claims specialist shall grow and develop his/her talents and insurance knowledge to the highest level possible.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Principle Duties and Responsibilities:
Directly responsible for the daily service requirements on assigned book of business including, but not limited to:
- Ordering loss runs as needed or requested.
- Ordering claim status on all open claims on a quarterly basis for specific clients as instructed or requested by producer and on an annual basis at renewal for remaining clients.
- Reviewing claim status reports and contacting adjuster as needed. Documentation is to be entered in TAM by way of activities.
- Preparing claim status reports on open claims for presentation to the agent and/or delivery to the client by correspondence or in person.
- Reviewing claim status reports and contacting adjuster as needed. Documentation is to be entered in TAM by way of activities.
- Reviewing (and processing) all workers’ compensation claims correspondence, including input of new claims in to TAM. Keep client TAM records, spreadsheets and summaries up-to-date.
- Receiving all workers’ compensation claim phone calls and faxes to advise and assist clients accordingly
- Maintaining automated files according to agency procedures, to include documentation by TAM activities
and claim notes for all calls and paperwork processed. - Keeping producers informed of all important activities on their accounts including being sensitive to potential problems and informing management.
- Completing other essential functions as assigned.
Education and / or Experience:
An adequate combination of education and experience in this field is required. Claims specialist should have thorough understanding of insurance industry, workers' compensation coverage and claim issues.
Knowledge, Skills and Abilities:
- Strong organizational skills; ability to discern priority and initiative.
- Computer skills, specifically Applied TAM, Microsoft Word, E-mail and Microsoft Excel.
- Excellent verbal and written communication skills as well as strong interpersonal skills.
- Reasoning Skills: - Ability to solve practical problems, interpret a variety of instructions and deal with a
variety of variables furnished in written, oral, diagram or schedule form.
DISCLAIMER - This is a shortened version of the job description, listing “some” of the key responsibilities that are normal to the position. Other duties may be assigned as needs arise or as required to support the essential functions. A more detailed job description will be provided upon request, to those candidates who are being considered for the position.
Contact Us
Send your resume to our Human Resources Department to the attention of: kkoch@wintonireland.com. Alternatively, you can send a cover letter and resume to:
Karen Koch, HR Director
Winton-Ireland, Strom & Green Insurance Agency
P.O. Box 3277
Turlock, CA
95381
