Senior Workers'' Compensation Claims Representative (Northeast)

biBerk Business Insurance Inc
  • NY
  • Remote
  • $92,000–$105,000 Per Year
  • Autofill and Review
4 days ago

Job Description

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Job Type

Full-time

Description

Berkshire Hathaway Direct Insurance Company (BHDIC) is the home of commercial small business insurance products biBerk Business Insurance and THREE by Berkshire Hathaway. Our Claims Department is seeking an experienced Workers' Compensation claims professional who combines strong technical claim handling and litigation management expertise with a passion for developing others. In addition to managing a caseload, this role serves as a key technical resource, providing mentorship, training, and guidance to a claims team, including direction on litigated claims. This position reports to a Workers' Compensation Claims Team Lead.

Location: This is a full-time remote position. This position may require occasional travel to attend mediations, trainings, and/or other related department meetings.

Job Responsibilities

The Senior Claims Representative will be responsible for, but not limited to:

  • Investigate coverage, determine compensability, and manage a pending of Workers' Compensation claims in multiple jurisdictions
  • Proactively establish and update reserves throughout the life of the claim to reflect claim exposure and document supporting rationale
  • Resolve claims within authority and make independent case value recommendations to senior leadership on cases which exceed authority
  • Participate in reserving, pricing and strategy discussions with leadership
  • Collaborate with outside defense counsel to effectively manage litigated files according to established litigation management guidelines
  • Partner with medical providers, customers, and injured workers to facilitate appropriate medical treatment and ensure timely submission of medical bills
  • Ensure compliance with state and federal Workers' Compensation regulations
  • Provide exceptional customer service to policyholders, agents, injured workers, medical providers, legal, and vendors
  • Document claim files in accordance with company and regulatory guidelines
  • Identify subrogation potential and red flags that require SIU involvement
  • Serve as a mentor to new and developing team members by providing ongoing coaching, technical guidance, and assisting with escalated issues
  • Lead onboarding and training activities for newly hired claims representatives
  • Partner with leadership to identify training opportunities, develop educational materials, and support continuous improvement initiatives within the Workers' Compensation claims department
  • Serve as a senior technical resource and mentor to less experienced claims representatives by providing guidance on complex claim issues, strategic decision-making, reserving, litigation management, and settlement evaluations.
  • Maintain continuing education requirements
  • Performs other duties as assigned

Requirements

Qualifications

  • Active adjuster license required
  • 7+ years of experience handling litigated workers' compensation claims
  • Excellent organizational and leadership skills
  • Experience with structured settlements and Medicare Set-Asides
  • Ability to work in a fast-paced, collaborative, virtual office environment
  • Strong analytical, organizational, and time management skills
  • Excellent written and verbal communication skills
  • Ability to work independently and meet assigned deadlines
  • Strong negotiation skills
  • Ability to multi-task and effectively prioritize tasks with frequent interruptions
  • Proficiency with MS Word, Excel and internet applications
  • Highly attentive to details
  • Able to work under pressure and execute good judgment in sensitive situations
  • Advanced verbal and written communication skills
  • Demonstrated experience training, mentoring, or coaching claims professionals in a Workers' Compensation environment

Education

  • BA/BS degree required
  • AIC, SCLA, CPCU, SIP or other industry designation a plus

About Us

biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBerk.com will be underwritten by Berkshire Hathaway Direct Insurance Company (''BHDIC''), which is an AM Best rated A++ insurer.

BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBerk are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.

BHDIC is excited to announce our comprehensive benefits package with some new and enhanced features for 2026 that include:

  • Medical (PPO/HDHP), vision, disability, and life insurance.
  • Enhanced dental plan with orthodontia coverage in addition to a standard plan.
  • Generous PTO plan for all benefit-time eligible employees.
  • Paid company holidays and 4 floating holidays.
  • Paid parental leave.
  • Employee Retirement Savings Plan/401(k) with company match and immediate vesting.
  • Education Assistance Program that offers 100% upfront tuition reimbursement after 6 months of service for approved degree programs.
  • Service Recognition Program that provides a monetary award to be used toward a vacation every 5 years of employment.
  • Wellness Initiatives that include Fitness Center and Weight Watchers Reimbursement programs.
  • Voluntary benefits that include accident, critical illness, and hospital indemnity.
  • Employee discount and rewards program on travel, tickets, electronics, home, and more.

In accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided. The salary range for this position is $92,000 - $105,000 per year. Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law. This position does not have bonus potential.

Numbers & Facts

LocationNY (
Remote
)
Salary$92,000–$105,000 Per Year

Skills

  • Analysis Skillsunmatched
  • Case Managementunmatched
  • Claims Processingunmatched
  • Coachingunmatched
  • Communication Skillsunmatched
  • Continuous Improvementunmatched
  • Customer Support/Serviceunmatched
  • Dental Insuranceunmatched
  • Disability Insuranceunmatched
  • Electronicsunmatched
  • Establish Prioritiesunmatched
  • File Managementunmatched
  • Fitnessunmatched
  • Healthcare Providersunmatched
  • Hospitalunmatched
  • Insuranceunmatched
  • Internet Applicationunmatched
  • Leadershipunmatched
  • Legalunmatched
  • Life Insuranceunmatched
  • Litigationunmatched
  • Litigation Settlementunmatched
  • Maintain Complianceunmatched
  • Medical Billingunmatched
  • Medical Treatmentunmatched
  • Medicareunmatched
  • Mentoringunmatched
  • Microsoft Excelunmatched
  • Microsoft Wordunmatched
  • Multitaskingunmatched
  • Negotiation Skillsunmatched
  • Onboardingunmatched
  • Organizational Skillsunmatched
  • People Managementunmatched
  • Preferred Provider Organization (PPO)unmatched
  • Presentation/Verbal Skillsunmatched
  • Product Pricingunmatched
  • Regulationsunmatched
  • Reimbursementunmatched
  • SIP (Session Initiation Protocol)unmatched
  • Small Businessunmatched
  • Subrogationunmatched
  • Support Documentationunmatched
  • Team Lead/Managerunmatched
  • Team Playerunmatched
  • Technical Leadershipunmatched
  • Time Managementunmatched
  • Training/Teachingunmatched
  • Training/Teaching Materialsunmatched
  • Willing to Travelunmatched
  • Worker's Compensationunmatched
  • Writing Skillsunmatched

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