WC Senior Claims Professional

4 days ago

Maitland, New South Wales, Australia beBeeClaims Full time US$74,300 - US$121,700
Claims Resolution Specialist

We are seeking an experienced Claims Resolution Specialist to fill this role.

This position involves handling commercial line Workers Compensation claims of moderate to high exposure and complexity, ensuring that claims are handled in the most efficient, effective way while delivering a customer-centric service.

The successful candidate will be responsible for:

  • Documenting claims files by accurately capturing and updating claims data/information in compliance with best practices for single and multi-party personal or commercial line claims of moderate to high exposure and complexity.
  • Exercising judgment to determine liability by gathering and analyzing relevant facts; utilizing applicable law; establishing basic principles of negligence.
  • Exercising judgment to determine policy verification and coverage determination by analyzing applicable coverage for claims and determining whether the loss falls within the coverage.
  • Working to achieve timely resolutions to claims by developing case strategy; developing a case evaluation; escalating issues as appropriate.
  • Establishing timely reserves and performing ongoing review throughout the claims cycle within authority limits by estimating and validating value of claims.
  • Assessing damages by calculating applicable damages or range of damages allowed by law.
  • Negotiating settlement of claim by establishing appropriate negotiation strategy and utilizing available tools and resources within authority limits.
  • Meeting quality standards by following best practices.

Qualifications include a Bachelor's Degree and 6 or more years of experience in the Claims and/or Litigation Management area. Alternatively, a Juris Doctor and 2 or more years of experience in the same field is also acceptable. The ideal candidate will possess excellent analytical skills, be able to work effectively in a team environment, and have strong communication skills.

Preferred qualifications include experience in the FLORIDA Work Comp Claims or Litigation Management area, as well as proficiency in multiple software applications. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.

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