WC Claims Representative 1

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    "city": "Minneapolis",
    "region": "MN",
    "country": "United States",
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    "url": "https://careers-berkley.icims.com/jobs/14032/wc-claims-representative-1/job",
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    "title": "WC Claims Representative 1",
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    "industry": "Financial ServicesInsurance",
    "datePosted": "2026-05-27T04:00:00.000Z",
    "description": "<h2>Company Details</h2>\n<p></p>\n<p> </p>\n<p>We’re a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.</p>\n<h2>Responsibilities</h2>\n<p>We’re a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.</p>\n<ul>\n <li>Investigate claims for compensability by analyzing claims-related information and applying claim handling guidelines.</li>\n <li>Verify active policy/coverage on new claims and determine if claim involves medical benefits only or includes exposure for lost time.</li>\n <li>Establish case reserves consistent with exposure on new claims. Examine reserves on a regular basis and adjust reserves if there is a significant change in exposure.</li>\n <li>Serve and file state forms when required.</li>\n <li>Investigate subrogation issues on claims, and place responsible third parties on notice of our client’s subrogation interest. Pursue subrogation or transfer file as appropriate.</li>\n <li>Receive and respond to telephone inquiries. This includes but is not limited to contact with injured employees, employers and health care providers.</li>\n <li>Authorize payment of bills for reasonable and necessary medical treatment, expenses associated with claims investigations and obtaining records. Send bills and records for audit when appropriate.</li>\n <li>Authorize or deny medical benefits within established time frames.</li>\n <li>Manage caseload with assistance of computer-operated diary and maintain current diaries.</li>\n <li>Participate in on-going training opportunities to remain current on all aspects of claims handling and customer service.</li>\n <li>Ensure timely filing of regulatory documents via EDI (Electronic Data Interchange); submit applicable claims to Index Bureau Reporting (ISO) and document files as applicable.</li>\n <li>Provide additional levels of management and claim department operational support to include payment review/approval/input and complete scheduled or special project work as needed.</li>\n</ul>\n<p><strong><em>May perform other functions as assigned</em></strong></p>\n<h2>Qualifications</h2>\n<ul>\n <li>Minimum of two years office experience or post-high school education.</li>\n <li>Ability to interpret and evaluate limited medical and limited legal concepts.</li>\n <li>Analysis and decision-making skills.</li>\n <li>Good to excellent math and analytical ability.</li>\n <li>Good oral and written communication skills.</li>\n <li>Willing to learn and apply negotiation techniques.</li>\n</ul>\n<p><strong>Education </strong></p>\n<ul>\n <li>High school diploma or equivalent</li>\n</ul>\n<h2>Additional Company Details</h2>https://www.berkleyrisk.com/ The Company is an equal employment opportunity employer. We do not accept unsolicited resumes from third party recruiting agencies or firms. The company offers a competitive compensation plan and robust benefits package for full time regular employees including: • Base Salary Range: $50k-$62k • Benefits include Health, dental, vision, dental, life, disability, wellness, paid time off, 401(k) and profit-sharing plans The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.\n<h2>Additional Requirements</h2>Travel: Occasional Travel",
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          "postalCode": "55402",
          "addressRegion": "MN",
          "streetAddress": "222 S 9th Street",
          "addressCountry": "US",
          "addressLocality": "Minneapolis",
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    "validThrough": "2027-05-27T04:00:00.000Z",
    "employmentType": "OTHER",
    "responsibilities": "We’re a member company of W. R. Berkley Corporation, an A. M. Best A+ rated Fortune 500 holding company. Berkley is comprised of individual operating units that serve a defined insurance market segment. Berkley Risk is focused on providing self-insured entities program administration services and insurance operations which can include taking or sharing risk using Berkley paper. This capability allows us to customize both an insurance company option and a purely administrative option for our customers.\r\n- Investigate claims for compensability by analyzing claims-related information and applying claim handling guidelines.\r\n- Verify active policy/coverage on new claims and determine if claim involves medical benefits only or includes exposure for lost time.\r\n- Establish case reserves consistent with exposure on new claims. Examine reserves on a regular basis and adjust reserves if there is a significant change in exposure.\r\n- Serve and file state forms when required.\r\n- Investigate subrogation issues on claims, and place responsible third parties on notice of our client’s subrogation interest. Pursue subrogation or transfer file as appropriate.\r\n- Receive and respond to telephone inquiries. This includes but is not limited to contact with injured employees, employers and health care providers.\r\n- Authorize payment of bills for reasonable and necessary medical treatment, expenses associated with claims investigations and obtaining records. Send bills and records for audit when appropriate.\r\n- Authorize or deny medical benefits within established time frames.\r\n- Manage caseload with assistance of computer-operated diary and maintain current diaries.\r\n- Participate in on-going training opportunities to remain current on all aspects of claims handling and customer service.\r\n- Ensure timely filing of regulatory documents via EDI (Electronic Data Interchange); submit applicable claims to Index Bureau Reporting (ISO) and document files as applicable.\r\n- Provide additional levels of management and claim department operational support to include payment review/approval/input and complete scheduled or special project work as needed.\r\nMay perform other functions as assigned",
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    "occupationalCategory": "Claims",
    "experienceRequirements": "Entry LevelAssociate"
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