Claims Representative Work Comp
Claims Representatives on SFM’s Risk Solutions Team manage an assigned caseload from self-insured clients or losses from the assigned risk plan. This involves investigating and determining liability on claims of reported injury or occupational disease; determining appropriate reserving; authorizing payment of medical and wage loss benefits; and assigning, directing, and monitoring medical, rehabilitation and legal services. They proactively reduce loss costs and improve the quality of claims management by identifying claim management issues. Also, they respond to customer inquiries and conduct field visits with TPA clients, brokers and injured workers. They identify trends and claims management practices that could impact TPA’s clients. The ability to interact with team members, TPA clients, brokers, legal counsel, physicians, nurses, rehabilitation consultants and injured workers is key.
--We’re looking for--
- Two to five years’ claims adjusting (workers’ compensation and/or casualty) experience required and can be substituted for four-year degree.
- Bachelor’s degree in insurance, risk management, business, psychology or related field preferred.
- Professional insurance designations (CPCU, ARM) a plus.
- Previous TPA experience a plus.
- Demonstrates a working knowledge of state applicable Workers’ Compensation Act and its application to claims administration.
- Demonstrates a working knowledge and skill in state regulatory reporting.
- Understanding of insurance finance and underwriting helpful.
- Exceptional oral communication skills in order to interact in a team environment and to collaborate with other business units and a diverse group of customers.
- Ability to assimilate, understand and analyze information from a variety of sources.
- Strong math and writing skills.
- Strong skills in investigating, negotiating and settling claims.
- Strong problem-solving and decision-making skills.
- Strong computer skills (preferably in a Windows environment), and the ability to work in a paperless environment.
- Effective prioritization, organization and time management skills.
- Strong customer service and interpersonal skills.
- Demonstrates positive teaming skills focused on team results.
- Knowledge of utilizing the internet to interact with state and regulatory agencies.
- APPLY! Find out why SFM employees have stuck around for 30+ years!
- Check Us Out @ www.sfmic.com/careers -or- https://www.youtube.com/user/SFMcompanies
Since 1983, SFM’s mission has been to be the workers’ compensation partner of choice for agents, employers, and their workers. While we’ve expanded to over 18,000 customers in the Midwest, and have grown our offerings to include vocational rehab, safe patient handling, loss prevention, medical services (and more!), our focus continues to be unrivaled customer service, injury prevention, and results.
SFM Mutual Insurance Company and each of its parent companies, subsidiaries and/or affiliated companies are Equal Opportunity/Affirmative Action Employers. All employment decisions are made without regard to race, color, religion, sex, national origin, age, sexual orientation, marital, familial, or veteran status, medical condition or disability, or any other legally protected classification.
SFM Companies, EEO/AA Employers.