FreshRemote.Work

Claims Recovery Representative - Workers' Compensation

Remote USA, United States

GENERAL SUMMARY OF DUTIES

The Workers Compensation Recovery Representative will be responsible for handling a desk of lower to moderate complexity subrogation claims for the workers compensation line of business: identifying, investigating, and negotiating recovery of all amounts owed to the Company due to contract, common law, or statute. By conducting detailed investigations, gathering evidence, coordinating site inspections, as well as utilizing both internal and external resources, the Workers Compensation Recovery Representative will identify liable third parties and formulate a course of action to pursue recovery against them. The Workers Compensation Recovery Representative will routinely work with attorneys, policyholders, claimants, and adverse insurance carriers to obtain and negotiate subrogation recoveries. The Workers Compensation Recovery Representative will report to the Recovery Unit Team Lead.

JOB RESPONSIBILITIES

The Workers Compensation Recovery Representative will maintain the following responsibilities pertaining to Subrogation Recovery:

  • Effectively manages a caseload of lower to moderate exposure subrogation claims, providing quality claims service, and appropriate resolutions in accordance with our claims handling guidelines achieving prompt claim recoveries, effective claim cost containment, and achievement of Claims recovery goals.
  • Determines responsible parties and whether responsible parties are insured or have available assets.  Conducts investigations that may include obtaining statements from witnesses, Insureds, and third parties and/or assigning experts to analyze and/or obtain necessary information. Directs experts during the course of investigation to gather evidence in order to prove liability and damages. Identifies and pursues recovery from responsible parties, their insurers, or both.
  • Issues demands and/or lien filings timely, and regularly contacts responsible parties and/or their insurers to ensure prompt and equitable payment and/or negotiated offsets.
  • Makes demands by telephone, letter, email, and/or other appropriate and approved means of communication to responsible parties and/or their insurers.
  • May contact local county or city attorneys to make restitution part of the criminal sentence and provides the necessary evidence to document the claim. Negotiates recovery of less than 100% when appropriate and within specified authority. Negotiates payment terms of promissory notes and customizes contracts for signature of debtor. Consults with management when recovery involves unusually complex issues or questions about liability or damages.                     
  • Maintains and regularly utilizes a diary system to ensure prompt follow up, completion of required actions and maximum available collection in all assigned files.  Maintains Claim Files in all applicable claims systems.  Determines and diaries statute of limitations date on all recovery files. Refers delinquent accounts to collection agency. Closes uncollectible files when situation demands.
  • Reviews open and closed Workers Compensation claims and evaluates for subrogation potential by a careful analysis of the facts surrounding the loss, the probable liability of each involved party, and the investigation needed to document the liability of and damages to be sought from the responsible party. Assists adjusters in identifying claims where subrogation and/or recovery opportunity applies as well as assists Recovery Unit Team Lead in the preparation and presentation of training modules to workers compensation adjusters.
  • Performs related duties as directed or as situation dictates, such as reviewing trade journals, case law, state statutes and insurance policies to remain current with changes in the law and coverages.   
  • Completes oversight tasks on recovery referrals being handled by third-party administrators.
  • Identifies and prepares claims ideal for submission to arbitration, including drafting arbitration demands. Follow guidelines required by Arb Forums, including meeting necessary deadlines.
  • Assists Recovery Team in hearing arbitration matters of outside parties, as warranted in the Company’s agreement with Arb Forums.

QUALIFICATIONS – REQUIRED EDUCATION, EXPERIENCE, AND SKILLS

  • Bachelor’s Degree from an accredited four-year college or university
  • At least two years of related work experience as a workers compensation recovery professional. Additional experience working as a workers compensation adjuster is a plus.
  • Knowledge of insurance contracts, statutory and common law, as well as state statutes and case law in key jurisdictions.
  • Critical Thinking: the ability to think critically and adapt quickly in a flexible and dynamic environment as well as maintain an inquisitive approach to work; the ability to derive appropriate conclusions based on available information and apply on the job.
  • Communication Skills: the ability to express concepts accurately, concisely, and professionally in both written and verbal communication.
  • Initiative and Organizational Skills: the ability to manage time effectively by prioritizing tasks, setting goals, and developing systems to work efficiently in achieving those goals within required timeframes, all within a remote environment. The ability to work proactively and independently.
  • Good Judgment: the ability to make prudent and timely decisions on the job within one’s scope of authority as well as seeking management direction as appropriate.
  • Math Proficiency: the ability to apply concepts such as fractions, percentages, ratios and proportions to practical claims situations as well as the capacity to analyze data, perform analysis, as well as identify issues and trends.
  • Technological Capability: Claims technical acumen complimented by strong workers compensation knowledge; data analytic skills to perform solid data collection, analysis and reporting; proficient in Excel and other Microsoft Office programs; knowledge of claims software systems as well as the ability to competently navigate proprietary and vended software programs.
  • Interpersonal Skills: the capability to develop and foster working relationships with stakeholders, both within and outside the organization. The ability to work well and negotiate with others, especially in confrontational situations.

About BHDIC

biBERK is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBERK.com will be underwritten by Berkshire Hathaway Direct Insurance Company ("BHDIC"), which is an AM Best rated A++ insurer.

BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBERK are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.

Some Highlights of our benefits are:

  • Great work environment with growth opportunity
  • Subsidized downtown parking
  • Competitive compensation
  • Generous amounts of vacation and sick time
  • Closed on major holidays
  • 401(k) with company match
  • A fantastic healthcare package
  • Tuition reimbursement after 6 months of employment


In accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided.  The salary range for this position is $65,000- $85,000 per year.  Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law.

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