Claims Representative (Workers Comp)

Posted 2 Days Ago
Be an Early Applicant
Hiring Remotely in US
Remote
70K-90K Annually
Entry level
Insurance
The Role
Manage complex workers’ compensation claims from investigation through resolution. Evaluate coverage, liability, damages, reserves, and settlements; negotiate with claimants, attorneys, and insureds; oversee litigated files; maintain documentation and quality standards; present recommendations; and mentor claims team members.
Summary Generated by Built In
Company Overview

Recognized as a Milwaukee Journal Sentinel Top Workplace for 14 consecutive years, including three years of being honored as number one! Join us at West Bend, where we believe that our associates are our greatest asset. We hire talented individuals who are conscientious, dedicated, customer focused, and able to build lasting relationships. We create and maintain an environment where you feel a sense of belonging and appreciation. Your diversity of thought, experience, and knowledge are valued. We’re committed to fostering a welcoming culture, offering you opportunities for meaningful work and professional growth. More than a workplace, we celebrate our successes and take pride in serving our communities.

Job Summary

Take ownership of complex workers comp claims from initial investigation through resolution, using your experience and judgment to make sound coverage, liability, and settlement decisions. This is an active claims desk, strong organization, time management, and the ability to effectively prioritize a busy workload are important to success.

Work Location

This position offers both remote and hybrid work locations.  Candidates who reside within 50 miles of an office location (West Bend, Madison, Appleton) will be offered a hybrid work schedule.  Candidates who are fully remote (beyond 50 miles) may occasionally be asked to travel to an office location for in-person engagement activities such as team meetings, training and corporate events. 

Responsibilities & Qualifications

Summary of Responsibilities

Take ownership of complex workers comp claims from initial investigation through resolution, using your experience and judgment to make sound coverage, liability, and settlement decisions. This is an active claims desk, strong organization, time management, and the ability to effectively prioritize a busy workload are important to success.


In this role, you’ll:

  • Manage complex and higher-exposure workers comp claims with minimal supervision.
  • Research policy language and develop well-supported coverage decisions.
  • Conduct thorough investigations and evaluate liability, damages, reserves, and settlement strategy.
  • Negotiate effectively with insureds, claimants, attorneys, and other involved parties.
  • Oversee litigated files and partner with counsel to develop appropriate resolution strategies.
  • Proactively manage a busy caseload while maintaining accurate reserves, timely follow-up, and strong file documentation.
  • Present complex claims to Committee and clearly communicate recommendations.
  • Collaborate with teammates and internal partners to resolve claims effectively.
  • Serve as a resource and mentor to others on the Claims team.
  • Deliver a high level of customer service while meeting department quality and audit standards.

Preferred Experience and Skills

We’re looking for an experienced claims professional who is comfortable managing a fast-moving, active desk and brings strong judgment, communication, and collaboration skills.

  • Prior experience handling large, complex, or higher-exposure claims.
  • Excellent written and verbal communication skills.
  • Strong investigation, negotiation, and problem-solving skills.
  • Strong time management, organization, and prioritization skills.
  • A team-oriented approach and willingness to collaborate and support others.
  • Strong interpersonal skills and the ability to work effectively with insureds, claimants, attorneys, and internal partners.
  • Comfort working independently and making decisions while knowing when to collaborate or escalate.
  • Proficiency with claims technology and other computer-based tools.
  • Experience handling claims in Nebraska, Kansas, and/or Missouri is preferred. Experience in Kansas and Missouri is especially valuable as we continue to grow in these markets.

Preferred Education and Training

  • Bachelor’s degree in Business, Insurance, or a related field.
  • Associate in Claims (AIC) designation.
  • Associate in General Insurance (AINS) designation.
  • CPCU coursework or other relevant insurance education or continuing professional development.

#LI-BW1

Salary Statement

The salary range for this position is $70,000-$90,000.   

  

The actual base pay offered to the successful candidate will be based on multiple factors, including but not limited to job-related knowledge/skills, experience, business needs, geographical location, and internal equity.  Compensation decisions are made by West Bend and are dependent upon the facts and circumstances of each position and candidate.  

Benefits

West Bend offers a comprehensive benefit plan including but not limited to:   


  • Medical & Prescription Insurance  
  • Health Savings Account  
  • Dental Insurance  
  • Vision Insurance  
  • Short and Long Term Disability  
  • Flexible Spending Accounts  
  • Life and Accidental Death & Disability   
  • Accident and Critical Illness Insurance  
  • Employee Assistance Program  
  • 401(k) Plan with Company Match  
  • Pet Insurance  
  • Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates 
  • Bonus eligible based on performance  
  • West Bend will comply with any applicable state and local laws regarding employee leave benefits, including, but not limited to providing time off pursuant to the Colorado Healthy Families and Workplaces Act for Colorado employees, in accordance with its plans and policies.
EEO

West Bend provides equal employment opportunities to all associates and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, and promotion.

Skills Required

  • Prior experience handling large, complex, or higher-exposure claims
  • Excellent written and verbal communication skills
  • Strong investigation, negotiation, and problem-solving skills
  • Strong time management, organization, and prioritization skills
  • Team-oriented approach and willingness to collaborate and support others
  • Strong interpersonal skills with insureds, claimants, attorneys, and internal partners
  • Ability to work independently, make decisions, and escalate when appropriate
  • Proficiency with claims technology and computer-based tools
  • Experience handling claims in Nebraska, Kansas, and/or Missouri
  • Bachelor's degree in Business, Insurance, or a related field
  • Associate in Claims designation
  • Associate in General Insurance designation
  • CPCU coursework or relevant insurance education or continuing professional development
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The Company
HQ: West Bend, WI
1,259 Employees
Year Founded: 1894

What We Do

We're hiring at West Bend! Check out our careers page on our website for updated listings. Since 1894, West Bend Mutual Insurance has come to stand for excellence through the use of innovative insurance products, steady growth, and financial stability offering property/casualty insurance for homes, autos, businesses and personal property. This reputation for excellence is recognized not only by our policyholders, but by the insurance industry itself. West Bend has been rated A (Excellent) or better by A.M. Best since 1971. West Bend is also consistently ranked at the top by thousands of insurance agents nationwide in an ease-of-doing-business survey conducted annually by Deep Customer Connections, Inc. Over a hundred years ago, a fire roared through the city of West Bend, WI. This tragedy was one of the worst for our community and touched the lives of many people. Because of that fire, our company was formed. And even then, we began to show that something good can come from something bad. Over time, people have come to expect this of us. To call with problems and leave with solutions. As time passes, things change. But not our reason for being. At the core of everything we do lies a simple premise. A sincere desire to help our customers through problems and adversity. To make sure that positives come from negative situations. To step up when you need us. To do the right thing. The worst brings out our best.® That's The Silver Lining.

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