Workers Compensation Stable Claims Adjuster

1 week ago

WilkesBarre, Pennsylvania, United States Berkshire Hathaway GUARD Insurance Companies Full time
Overview

Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group – one of the financially strongest organizations in the world Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide.

Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values:  accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path

Benefits:

We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer

  • Competitive compensation
  • Healthcare benefits package that begins on first day of employment
  • 401K retirement plan with company match
  • Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays
  • Up to 6 weeks of parental and bonding leave
  • Hybrid work schedule (3 days in the office, 2 days from home)
  • Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation)
  • Tuition reimbursement after 6 months of employment
  • Numerous opportunities for continued training and career advancement
  • And much more
Responsibilities

We are seeking a detail-oriented and dependable Workers Compensation Stable Claims Adjuster to manage a high-volume caseload of approximately 600–700 stable workers compensation claims across multiple jurisdictions. This role is ideal for professionals who thrive in structured environments and are committed to ensuring accurate and timely claim handling.

What You'll Do
  • Manage all aspects of stable claims, including:
    • Monitoring and processing ongoing benefits.
    • Reviewing and paying reasonable, necessary, and related medical bills.
    • Denying unrelated or unnecessary medical expenses.
    • Conducting mandatory reserve reviews and adjusting reserves as needed.
    • Filing reinsurance reports as required.
    • Resolving system alerts and maintaining claim documentation.
    • Updating claim status and plan of action (POA) tabs periodically.
    • Working toward claim resolution when appropriate.
    • Reassigning claims to the Complex Claims Unit (CCU) if they no longer meet stability criteria.
What Makes a Claim "Stable"

A claim may be considered stable when:

All compensability and legal issues are resolved.No further investigation is needed regarding treatment or injury relation.Medical treatment is routine and predictable.Long-term indemnity benefits are scheduled for automatic processing (e.g., Permanent Total Disability, Widow Benefits).Qualifications
  • Proven experience in workers compensation claims adjusting.
  • Ability to manage a large caseload efficiently and accurately.
  • Strong analytical and decision-making skills.
  • Excellent communication and organizational abilities.
  • Required state licenses and continuing education credits (must be obtained and maintained).

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