Workers Compensation Claims Representative

De Witt, NY Full Time
POSTED ON 5/14/2024
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. This individual contributor position works under direct supervision, and within defined authority limits, to manage commercial claims with low to moderate complexity and exposures 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 accounts(s). JOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Manages an inventory of low to moderate complexity and exposure commercial claims by following company protocols to verify policy coverage, gather necessary information, maintain appropriate file documentation and authorize disbursements within authority limit. Contributes to customer satisfaction 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, estimating potential claim valuation, and following company's claim handling protocols. Exercises judgement to determine liability and compensability by conducting investigations to gather pertinent information, taking recorded statements from insureds, witnesses and working with experts to verify the facts of the claim. Works with appropriate internal and external partners, suppliers and experts by identifying and effectively collaborating with necessary resources to facilitate best claim outcomes. Authorizes and ensures claim disbursements within authority limit by determining liability and compensability of the claim, negotiating settlements and escalating to manager as appropriate. Developing ability to manage expenses 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 Claim, 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 perform additional duties as assigned. Reporting Relationship Typically Manager or above Skills, Knowledge & Abilities Developing basic knowledge of the commercial insurance industry, products and claim practices. Good verbal and written communication skills with the ability to demonstrate empathy while providing exceptional customer service. Ability to develop collaborative business relationships with both internal and external work partners. Able to exercise independent judgement, solve basic problems and make sound business decisions. Analytical mindset with critical thinking skills. Strong work ethic, with demonstrated time management and organizational skills. Ability to manage multiple priorities in a fast-paced, collaborative environment at high levels of productivity. Knowledge of Microsoft Office Suite and ability to learn business-related software. Adaptable to a changing environment Ability to value diverse opinions and ideas Education & Experience: High school Diploma required. Associates or Bachelor's Degree preferred. Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Prior claim handling, or business experience in the insurance industry and/or customer service is preferred. In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In California, Colorado, Connecticut, New York and Washington, the national base pay range for this job level is $44,000 to $74,000 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. At CNA, we are focused on success, individually and collectively. We pride ourselves on promoting a culture that challenges and engages people. We strive to connect people, departments and business areas, to function as a team, and to serve our customers and communities with professionalism and respect. Our dedication to employee engagement, continuous learning and the open exchange of ideas is the cornerstone of our business. These ideals, combined with our focus on the customer, enable us to explore new market opportunities and build on our success. Our values, culture and financial strength are what differentiates us from other employers and make CNA the place you want to work. CNA is committed to fostering a diverse and inclusive culture grounded in equity that supports our organization, clients, and communities by prioritizing talent and programs that represent our current environment and empower all employees and partners to be active allies and advocates for equality. Globally, our Employee Resource Groups — Advocacy for Visible & Invisible Disabilities (AVID), Asian Professionals for Excellence (APEX), Empowering Black Professionals (EBP), Generational Perspectives (GP), Organization of Hispanics and Latine Americanos (¡OHLA!), Pride, Women Impacting Leadership (WIL) and Veterans — make CNA, and our communities, even stronger. At CNA, we have a long standing commitment to the diverse communities in which we live and work. We actively make a difference for the greater good through partnerships, sustainability, initiatives, and working together for a better tomorrow. Corporate Social Responsibility is not one person, or one department, it's the entire enterprise coming together to make the world a better place.

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