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Workers Compensation Claims Technical Specialist – East
Berkshire Hathaway GUARD Insurance Companies. Partner with the Claims Director to manage high-exposure workers compensation claims, including catastrophic injuries, serious loss exposures, and other complex matters in the East region .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing high-exposure workers compensation claims, including advanced negotiation, case resolution, and thorough knowledge of regulatory laws and statutes. Capable of collaborating with medical and legal resources to achieve optimal claim resolutions and facilitate effective communication with stakeholders.
Highest-signal resume keywords
Workers Compensation ExperienceAdvanced Negotiation SkillsAnalytical Thinking SkillsKnowledge of Regulatory LawsAdvanced Investigative Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ManagementCase ResolutionMedical Treatment ManagementLoss Exposure AnalysisStatutory Benefit EntitlementReserving TechniquesSettlement AssessmentLiability DeterminationFile ReviewTraining Recommendations
Soft Skills
Clear CommunicationProblem IdentificationInfluencing StakeholdersPresentation SkillsCollaboration
Industry Keywords
Workers CompensationInsurance RegulationsLegal ProceedingsMedical DiagnosesMedicare Set AsideClaims Unit CollaborationDisability ProjectionsInvestigative TechniquesChain of CustodyTrial Preparation
About the role
Key responsibilities & impact- Partner with the Claims Director to manage high-exposure workers compensation claims, including catastrophic injuries, serious loss exposures, and other complex matters in the East region
- Serve as a technical resource to claims professionals
- Collaborate with medical and legal specialty resources to manage medical treatment and lost-time benefits in extremely complex or potentially high-financial-exposure cases
- Co-manage claims with the Claims Unit, including disability and treatment projections, reserving, and investigative suggestions for complex or catastrophic losses
- Develop strategies for statutory benefit entitlement, medical diagnoses, Medicare Set Aside, and injury severity issues to achieve optimal resolution
- Facilitate timely claim resolution by leveraging mitigation opportunities
- Participate in reserving and strategy discussions with claim handlers and senior management
- Identify staff skill gaps and collaborate on training recommendations across service offices
- Support administrative tasks, respond to inquiries, and assist with operational research
- Participate in telephonic and/or onsite file reviews
Requirements
What you’ll need- College degree or 5+ years Workers Compensation experience
- Analytical thinking skills, including problem identification, information analysis, cause/effect analysis, and evaluation of alternative solutions
- Clear and concise oral and written communication skills
- Ability to effectively present file resolution to internal and/or external stakeholders
- Advanced negotiation and case resolution skills
- Ability to understand alternatives, influence stakeholders, and reach fair agreements through discussion and compromise
- Advanced investigative skills, including ability to take statements
- Advanced ability to determine liability, assign dollar values based on claimed damages and estimates, and set and readjust reserves
- Advanced ability to assess settlement methods, timing of offers, and settlement offer package contents
- Thorough knowledge of state, federal, and regulatory laws and statutes; rules of evidence; chain of custody; trial preparation and discovery; court proceedings; and insurance-industry regulations
- Candidates are ideally based out of Wilkes-Barre, PA
- Candidates must participate independently in interviews; unauthorized recording, transcription, AI note-taking, or AI interview assistance tools are prohibited without prior approval
Benefits
Comp & perks- Hybrid schedule: 2 days remote / 3 in-office
- Predictable hours (no nights, weekends, or holidays)
- Competitive pay + generous PTO
- Medical, dental & vision starting day one
- 401(k)
- Tuition reimbursement
- Longevity bonuses