WC Claims Representative (Hybrid/Remote)

About the position

The Workers Comp Claims Representative at Selective Insurance is responsible for managing lost-time claims, ensuring effective communication with all parties involved, and making timely decisions regarding coverage and compensability. This hybrid role allows for a combination of in-office and remote work, focusing on providing excellent customer service while adhering to regulatory guidelines.

Responsibilities
• Receive assigned lost-time claims for investigation to determine coverage and compensability on claims with a short disability period of 8 weeks or less.
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• Process claims which include making contacts, setting reserves, establishing files in MCS, evaluating exposure, and establishing initial and subsequent reserves on less severe claims.
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• Document claim files and maintain control of work through documentation or diary system.
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• Handle non-litigated claims only.
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• File state forms timely in accordance with statutory guidelines.
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• Collaborate with nurses and vendors on medical and disability management.
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• Prepare for and participate in claims review and settlement conferences.
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• Ensure compliance with company, state and federal regulations.

Requirements
• 1 year of experience in claims management or a related field.
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• Less than high school education.

Nice-to-haves
• Experience in the insurance industry.
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• Familiarity with workers' compensation claims processes.

Benefits
• Comprehensive health care plans.
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• Retirement savings plan with company match.
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• Discounted Employee Stock Purchase Program.
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• Tuition assistance and reimbursement programs.
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• Paid time off plans.

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