Workers Compensation Claims Specialist

1 month ago


Wyomissing, Pennsylvania, United States CNA Full time

Job Summary

We are seeking a highly skilled Workers Compensation Claims Consultant to join our team at CNA. As a key member of our claims team, you will be responsible for managing complex investigations of claims, determining liability and compensability, and implementing effective resolution strategies.

Key Responsibilities

  • Manage highly complex investigations of claims, including coverage issues, liability, and damages.
  • Determine if a major claim should be settled or litigated and implement an appropriate resolution strategy.
  • Effectively manage loss costs and claim expenses.
  • Manage all types of investigative activity or litigation on major claims, including the posting of appropriate reserves in a timely manner.
  • Negotiate highly complex settlement packages and authorize payment within scope of authority.
  • Coordinate third-party recovery with subrogation/salvage unit.
  • Make recommendations on claims processes and resolution strategies to management.
  • Analyze claims activities and prepare and present reports to management and other internal business partners and clients.
  • Work with attorneys, account representatives, agents, doctors, and insureds regarding the handling and/or disposition of highly complex claims.
  • Keep current on state/territory regulations and issues, industry activity, and trends.
  • Provide guidance and assistance to less experienced claims staff and other functional areas.

Requirements

  • Advanced technical and product-specific expertise, claims resolution skill, and knowledge of insurance and claims principles, practices, and procedures.
  • Strong communication, negotiation, and presentation skills.
  • Advanced analytical and problem-solving skills, with the ability to manage and prioritize multiple projects.
  • Ability to deal with ambiguous situations and issues.
  • Creativity in resolving unique and challenging business problems.
  • Knowledge of Microsoft Office Suite and other business-related software.
  • Ability to adapt to change and value diverse opinions and ideas.
  • Ability to manage and prioritize multiple projects.
  • Ability to evaluate claims based on a cost-benefit analysis.
  • Ability to fully comprehend complex claim facts and issues and to further articulate analyses of claims in presentations to business partners and management as well as in internal reports.
  • Ability to implement strategies with a proactive long-term view of business goals and objectives.

Education and Experience

  • Bachelor's degree or equivalent experience.
  • Typically a minimum eight years of claims experience.


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