Disability Claims Examiner, Sr. jobs in Kentucky

WHO WE ARE:

Harford Mutual Insurance Group is a growing, dynamic community partner located in Bel Air in Harford County, Maryland, offering a positive, diverse, and inclusive work environment with a rich company culture. We provide commercial property and casualty insurance products and services to a regional market. Founded in 1842 on the principles of mutuality for our business clients, our agents, and our company, we believe in insuring opportunity through mutual success® and invite our employees to continue that tradition with respect, integrity, exemplary service, and personal responsibility.

THE OPPORTUNITY

The Senior Claims Examiner - Workers' Compensation investigates, evaluates, and resolves workers’ compensation claims and makes recommendations for resolutions from any of Harford Mutual Insurance Group companies.  The incumbent will be expected to handle efficiently and competently medium to high severity claims, and to possess comprehensive knowledge of all coverages and claims handling procedures while providing quality claims service to policyholders and agents.  

WHAT YOU’LL DO: 

• Conducts prompt and thorough investigations of workers’ compensation claims within departmental and regulatory guidelines through telephone, written, and other communication methods with policyholders, claimants, attorneys, witnesses, and others with pertinent information.
• Advocates for the injured worker and engages with nurse case management to mitigate lost time and facilitate a return-to-work.
• Demonstrates specialized handling of lost time and lifetime medical cases with focus on long term cost-containment and injured worker advocacy.
• Provides quality claims service to our policyholders and agents by remaining in constant communication with them throughout the claim lifecycle.
• Evaluates coverage, determines compensability, utilizes negotiation skills to resolves claims within authority to include ability to draft the respective communications required on the claim.
• Analyzes information to evaluate assigned claims to determine the extent of loss, taking into consideration coverage, compensability, and future investigation needs. Assign and manage nurse case managers, defense counsel, or other experts on a task assignment basis where necessary.
• Demonstrate in-depth understanding of workers’ compensation statutes, jurisdictional formwork, regulatory requirements, and changing legal landscape.     
• Accurately apply the HMIG reserving practice by continually evaluating claim exposure to establish appropriate and timely reserves over the life of the claim and notify claim management when exposure exceeds authority.
• Establish and execute appropriate action plans to manage claims proactively and promptly with a strategic plan for optimal claim outcomes.  
• Maintain a claim diary and comply with departmental diary procedures.
• Excellent organization and problem-solving skills along with the ability to multi-task and prioritize to ensure that all claims are handled efficiently and effectively.
• Direct and handle subrogation and loss recovery efforts on assigned files.
• Continuing education on insurance and claims matters.

Performs other duties or special projects as required or as assigned by a supervisor.

WHAT YOU’LL BRING:

• Four-year college degree; or comparable claims work experience
• Over 5 years’ experience in progressive claims roles

• Licenses/Certifications:

  AIC or similar designation

WHO YOU ARE: 

•    Ability to understand and analyze policy coverages
•    Ability to analyze information to determine compensability 
•    Strong negotiation skills
•    Strong collaborating skills, and an ability to work effectively both independently and as part of a team
•    Comfortable in a fast-paced environment with frequent deadlines; high energy, self-motivated and proactive
•    Excellent communication and interpersonal skills to convey complex data and information to audiences with varying levels of expertise
•    Ability to multitask, and be flexible regarding workload and assignments
•    Ability to exercise judgment
•    Strong organizational skills and time management of claims desk 
•    Maintain valid adjusters’ license(s) in states assigned or an ability to obtain same
 

OTHER REQUIREMENTS

Physical Requirements:

The physical demands are minimal and typical of similar jobs in comparable organizations.

Americans with Disabilities Act (ADA):

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties of the position.

The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified.  Furthermore, they do not establish a contract for employment and are subject to change at the discretion of Harford Mutual

Visit our Careers Page for more information on our competitive compensation/benefits packages.