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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