Claims Specialist, Workers Compensation

4 weeks ago

Downers Grove, United States CNA Insurance Full time $49,000 - $98,000
You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.

Check below to see if you have what is needed for this opportunity, and if so, make an application asap.

This individual contributor position works under moderate direction, and within defined authority limits, to manage commercial claims with moderate to high complexity and exposure for a specific line of business. Responsibilities include investigating and resolving claims according to company protocols, quality and customer service standards. Position requires regular communication with customers and insureds and may be dedicated to specific account(s).

JOB DESCRIPTION:

Essential Duties & Responsibilities:

Performs a combination of duties in accordance with departmental guidelines:

Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize disbursements within authority limits.

Provides exceptional customer service by interacting professionally and effectively with insureds, claimants and business partners, achieving quality and cycle time standards, providing regular, timely updates and responding promptly to inquiries and requests for information.

Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters , estimating potential claim valuation, and following company's claim handling protocols.

Conducts focused investigation to determine compensability, liability and covered damages by gathering pertinent information, such as contracts or other documents, taking recorded statements from customers, claimants, injured workers, witnesses, and working with experts, or other parties, as necessary to verify the facts of the claim.

Establishes and maintains working relationships with appropriate internal and external work partners, suppliers and experts by identifying and collaborating with resources that are needed to effectively resolve claims.

Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate.

Contributes to expense management by timely and accurately resolving claims, selecting and actively overseeing appropriate resources, and delivering high quality service.

Identifies and addresses subrogation/salvage opportunities or potential fraud occurrences by evaluating the facts of the claim and making referrals to appropriate Recovery or SIU resources for further investigation.

Achieves quality standards on every file by following all company guidelines, achieving quality and cycle time targets, ensuring proper documentation and issuing appropriate claim disbursements.

Maintains compliance with state/local regulatory requirements by following company guidelines, and staying current on commercial insurance laws, regulations or trends for line of business.

May serve as a mentor/coach to less experienced claim professionals

May perform additional duties as assigned.

Reporting Relationship

Typically Manager or above

Skills, Knowledge & Abilities

Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.

Solid verbal and written communication skills with the ability to develop positive working relationships, summarize and present information to customers, claimants and senior management as needed.

Demonstrated ability to develop collaborative business relationships with internal and external work partners.

Ability to exercise independent judgement, solve moderately complex problems and make sound business decisions.

Demonstrated investigative experience with an analytical mindset and critical thinking skills.

Strong work ethic, with demonstrated time management and organizational skills.

Demonstrated ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity.

Developing ability to negotiate low to moderately complex settlements.

Adaptable to a changing environment.

Knowledge of Microsoft Office Suite and ability to learn business-related software.

Demonstrated ability to value diverse opinions and ideas

Education & Experience:

Bachelor's Degree or equivalent experience.

Typically a minimum four years of relevant experience, preferably in claim handling.

Candidates who have successfully completed the CNA Claim Training Program may be considered after 2 years of claim handling experience.

Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable.

Professional designations are a plus (e.g. CPCU)

#LI-AR1

#LI-Hybrid

In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Maryland, New York and Washington, the national base pay range for this job level is $49,000 to $98,000 annually. Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees – and their family members – achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA’s benefits, please visit cnabenefits.com.

CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact leaveadministration@cna.com.

  • Workers' Compensation Claims Specialist

    4 weeks ago

    Downers Grove, Illinois, United States CorVel Enterprise Comp, Inc. Full time

    Job SummaryCorVel Enterprise Comp, Inc. is seeking a skilled Workers' Compensation Claims Specialist to join our team. As a key member of our claims department, you will be responsible for managing lower-level, non-complex and non-problematic Medical Only workers' compensation claims, as well as Lost Time claims involving greater complexity.Key...

  • Workers' Compensation Claims Specialist

    3 weeks ago

    Downers Grove, Illinois, United States CorVel Corporation Full time

    Job SummaryThe Claims Specialist plays a crucial role in managing lower-level, non-complex workers' compensation claims, as well as more complex lost-time claims. This position requires strong analytical and communication skills, with the ability to work independently and as part of a team.Key ResponsibilitiesReceive and process claims, confirming policy...

  • Workers' Compensation Claims Specialist

    2 days ago

    Downers Grove, Illinois, United States CorVel Enterprise Comp, Inc. Full time

    Job SummaryThe Claims Specialist role at CorVel Enterprise Comp, Inc. involves managing lower-level, non-complex and non-problematic Medical Only workers' compensation claims, as well as Lost Time claims involving greater complexity. This position requires strong communication and problem-solving skills, with the ability to learn rapidly and develop...

  • Medical Claims Specialist

    4 days ago

    Downers Grove, Illinois, United States CorVel Enterprise Comp, Inc. Full time

    Job SummaryWe are seeking a highly skilled Medical Claims Specialist to join our team at CorVel Enterprise Comp, Inc. This role will involve managing non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision.The ideal candidate will have excellent customer service skills, strong written and...

  • Medical Claims Specialist

    2 days ago

    Downers Grove, Illinois, United States CorVel Enterprise Comp, Inc. Full time

    Job SummaryCorVel Enterprise Comp, Inc. is seeking a skilled Medical Claims Specialist to manage non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision.Key Responsibilities:Confirm policy coverage and acknowledge claimsDetermine claim validity and compensabilityEstablish reserves and...

  • Claims Specialist

    2 weeks ago

    Downers Grove, Illinois, United States CorVel Corporation Full time

    Job Title: Claims SpecialistCorVel Corporation is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for managing complex and problematic liability claims within delegated limited authority to determine benefits due, manage subrogation, and negotiate settlements to ensure specific customer service...

  • Claims Specialist, Insurance Industry

    5 days ago

    Downers Grove, Illinois, United States CNA Full time

    Job Title: Claims Specialist, Workers CompensationJob Summary:CNA is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for managing commercial claims with moderate to high complexity and exposure for a specific line of business.Key Responsibilities:Investigate and resolve claims according to company...

  • Claims Specialist

    4 days ago

    Downers Grove, Illinois, United States CorVel Corporation Full time

    Job SummaryThe Liability Claims Specialist manages complex and problematic liability claims within delegated limited authority to determine benefits due; manage subrogation and negotiate settlements to ensure specific customer service requirements to achieve the best possible outcome in the claim, supporting the goals of the claims department and of...

  • Medical Only Claims Specialist

    2 months ago

    Downers Grove, United States CorVel Corporation Full time

    The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgement of the claim ...

  • Medical Only Claims Specialist

    5 months ago

    Downers Grove, United States CorVel Corporation Full time

    The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers’ compensation claims under close supervision, supporting the goals of claims department and of CorVel. The positions is remote. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and...

  • Nurse Medical Case Manager

    4 months ago

    Downers Grove, United States Travelers Full time

    Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine...

  • Claims Supervisor

    5 days ago

    Downers Grove, Illinois, United States CorVel Corporation Full time

    Job Title: Claims SupervisorJob Summary: CorVel is seeking a Claims Supervisor to join our team. As a Claims Supervisor, you will be responsible for supervising a team of claims staff, ensuring quality, productivity, and customer service criteria are met while adhering to company policies and procedures.Key Responsibilities:Supervise claims staff in their...

  • Claims Supervisor

    4 weeks ago

    Downers Grove, Illinois, United States CorVel Corporation Full time

    Job Title: Claims SupervisorCorVel Corporation is seeking a highly skilled Claims Supervisor to join our team. As a Claims Supervisor, you will be responsible for supervising a team of claims staff, ensuring that all quality, productivity, and customer service criteria are met while adhering to company policies and procedures.Key Responsibilities:Supervise...

  • Claims Supervisor

    3 weeks ago

    Downers Grove, Illinois, United States CorVel Enterprise Comp, Inc. Full time

    Job Title: Claims SupervisorCorVel Enterprise Comp, Inc. is seeking a Claims Supervisor to join our team. As a Claims Supervisor, you will be responsible for supervising a team of direct reports, ensuring all quality, productivity, and customer service criteria are met while adhering to company policies and procedures.Key Responsibilities:Supervise claims...

  • Claims Support Specialist

    3 weeks ago

    Downers Grove, Illinois, United States GB - Global Full time

    About the RoleWe are seeking a highly organized and detail-oriented Claims Technical Assistant to join our team at GB - Global. As a Claims Technical Assistant, you will provide clerical and administrative support to our field offices, processing data, generating routine reports, and providing direct support to claim representatives.Key ResponsibilitiesUnder...

  • Regional Claims Adjuster

    2 weeks ago

    Downers Grove, Illinois, United States Gallagher Full time

    IntroductionGallagher Bassett is a leading provider of claims management services, and we're seeking a skilled Regional General Adjuster to join our team. As a key member of our Claims Adjuster team, you will play a critical role in investigating, evaluating, and resolving complex Commercial Property claims.Our team is dedicated to delivering exceptional...

  • Regional Claims Adjuster

    4 weeks ago

    Downers Grove, Illinois, United States Gallagher Full time

    IntroductionGallagher is a leading provider of claims management services, and we're seeking a skilled Regional General Adjuster to join our team. As a key member of our Claims Adjuster team, you will play a critical role in investigating, evaluating, and resolving complex Commercial Property claims.Our team is dedicated to delivering exceptional customer...

  • Complex Claims Specialist – Allied Healthcare Providers

    5 months ago

    Downers Grove, United States CNA Full time

    JOB DESCRIPTION : Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of moderate to high complexity and exposure Healthcare claims by following company protocols to verify policy coverage, conduct investigations, develop and employ resolution strategies, and authorize...

  • Claims Supervisor

    2 days ago

    Downers Grove, Illinois, United States CorVel Corporation Full time

    CorVel Corporation is seeking a seasoned Claims Supervisor to lead our team of professionals in handling Auto and General Liability claims. The ideal candidate will have a strong background in claims management, excellent leadership skills, and the ability to motivate and develop a team.Key Responsibilities:Supervise a team of claims professionals in their...

  • Risk Management Specialist

    4 days ago

    Downers Grove, Illinois, United States CorVel Corporation Full time

    Job Summary:The Risk Management Specialist will be responsible for interacting with customers and prospects on an executive level, acting as an extension of the client, and selling new services. The ideal candidate will have a proven track record of closing business in claims and/or managed care services, preferably in the casualty market.Key...