Claims Adjuster - Senior Level

Berkshire Hathaway Homestate Companies - San Francisco, CA (30+ days ago)3.6


NOTE: BHHC does not conduct interviews via social media (e.g. Google hangout, LinkedIn, etc.). Please be aware that any such contact is fraudulent and we advise that you not provide any personal information.

WHO WE ARE
As a member of the Berkshire Hathaway group of insurance companies, we offer outstanding opportunities for professionals interested in working with a successful company. We offer unparalleled financial strength, stability and “large company” benefits, in addition to an exciting, friendly, “small company” atmosphere.

POSITION DESCRIPTION
Berkshire Hathaway Homestate Companies has an opening in our San Francisco location for a Claims Examiner. By performing the following duties personally and guiding the work activities of other staff, Claims Examiners manage a caseload of Workers Compensation indemnity cases from inception to resolution. Assigns appropriate tasks to a Claims Assistant. This position requires a self-starter who can work under a minimal, achieve defined results and accept ownership for their work product.

ESSENTIAL RESPONSIBILITIES

Determine coverage for new claims and take appropriate action on any coverage issues.
Conduct and direct the investigation of new claims to determine severity and to gather all other relevant information, including making three point contact telephone calls.
Calculate appropriate reserves for each claim and ensure that reserves are adjusted as needed.
Calculate and pay indemnity benefits.
Ensure that other benefits are provided in accordance with the law and that the claim as a whole is managed in accordance with all legal requirements including the issuance of appropriate notices and filings.
Develop and update a plan of action for the successful resolution of each claim.
Manage each claim to an appropriate and successful resolution.
Make prompt, sound decisions on issues that arise in claims.
Ensure that work is performed in accordance with Company standards, training, and supervisory direction.
Contribute to the achievement of the Claim Unit’s goals.
Ensure that the actions of all other professionals involved in managing a claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve an appropriate and successful resolution of the claim.
Assign appropriate tasks to a Claims Assistant and ensure they are performed correctly and efficiently.
Recommend claim settlement at the appropriate time and value, and effectively negotiate the settlement of claims.
Foster a positive and close working relationship with other Company staff, including the call center, medical management, special investigations, legal, nurse case management, the call center, client services, marketing, and underwriting.
Communicate effectively with individuals outside the company, including clients, medical providers, and injured workers.

QUALIFICATIONS
Education and Experience: Bachelor's degree from an accredited college or university; or at least three years of relevant experience and training; or an equivalent combination of education and experience.
Language Ability: Able to read and interpret complex documents including statutes, regulations, legal opinions, legal letters, medical records, medical bills, medical resource materials, investigation reports, claim notes, and claim data fields. Able to write clear, concise reports accurately conveying complex and nuanced information. Able to write clear, effective correspondence on complex medical and legal points to people from all walks of life. Able to effectively present information and respond to questions with managers, clients, claimants, attorneys, medical providers, and others. Able to investigate, persuade, and negotiate over the telephone.
Math Ability: Able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Able to compute rate, ratio, and percent. Familiar with the time value of money and reducing future streams of payments to a present value. Familiar with the concept of statistical likelihood as the basis for calculating the value of a possible financial outcome.
Reasoning Ability: Able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Able to deal with problems involving several concrete variables in standardized situations.
Computer Skills: Knowledge of Microsoft Office software. Able to quickly master proprietary and vended software applications.
Certificates and Licenses: Licensed to adjust workers’ compensation claims in one or more jurisdictions.

COMPREHENSIVE BENEFITS PACKAGE:
Health and wellness – low premiums for medical, dental and vision coverage, FSA and EAP benefits
Company paid Life, Disability and ADD benefits
Employee Retirement Savings Plan with employer match up to 5 percent of compensation
Generous Paid Time Off and Holidays
Education Assistance Reimbursement
Recognition and Rewards Programs
Company Store
Discounts across Berkshire Hathaway Inc. companies such as GEICO, See’s Candies, etc.

ABOUT US:
The Berkshire Hathaway Homestate Companies (BHHC) is a group of six insurance companies that are part of the Berkshire Hathaway Insurance Group. Our Workers Compensation Division provides premier workers compensation insurance coverage to employers across the country, with offices in San Francisco, San Diego, Sacramento, Pasadena, Omaha, Philadelphia, St. Louis, Atlanta, and Dallas.

As a member of the Berkshire Hathaway Insurance Group, BHHC has earned an enviable record of success in the insurance industry that is supported by an A++ A.M. Best rating for the last 10 consecutive years. Our corporate size enables our organization to react swiftly and effectively to opportunities in the insurance marketplace. At the same time, our financial strength provides our agents and insureds security and makes us one of the best brands in the marketplace.

We value each individual and recognize that attracting and retaining high quality talent is essential to the success of our company. Our structure minimizes bureaucracy and creates an environment that encourages our employees to see the direct effects of their hard work throughout the company. Each division provides hands on training and maintains a small company feel, creating an atmosphere in which 'team players' thrive.

Within the last six years BHHC Workers Compensation has seen significant growth, and we’re continuing to grow as we build one of the largest Workers Compensation companies in the country – join us!

This organization participates in E-Verify. For more information on E-Verify, please contact DHS: 888.897.7781 www.dhs.gov/E-Verify.

We will consider for employment qualified applicants with criminal histories as required by local ordinance.Additionally, no applicant will be denied employment solely on the grounds of conviction of a criminal offense except to the extent necessary to obtain a necessary license or to comply with The Violent Crime Control and Law Enforcement Act of l994, which prohibits the employment by an insurance company of persons convicted of certain crimes, unless a waiver is obtained.