Claim Representative II

• Administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.
• Exercises independent judgment to settle cases prior to mediation or litigation.
• Actively participates in agent/client relationship management.
• Assists in mentoring team members.

• Mentors team members.
• Conducts audits of claim files.
• Acts as a back up for team leader.
• Coordinates special projects.

This position description identifies the responsibilities and tasks typically associated with the performance of the position.

Other relevant essential functions may be required.

Bachelor’s degree in a related field.

Relevant combination of education and experience may be considered in lieu of degree.

Continuous learning, as defined by the Company’s learning philosophy, is required.

Certification or progress toward certification is highly preferred and encouraged.

Minimum one-year relevant experience that provides the necessary skills, knowledge and abilities or completion of claims trainee program .

Bilingual skills preferred.

Three years’ experience in a workers’ compensation claims environment which provides the necessary skills, knowledge, and abilities, such as experience in reviewing, investigating, and closing workers’ compensation claims.

of handling claims in multiple jurisdictions preferred.

Bilingual skills preferred.

One year of AF Group Claims Representative I experience that includes handling of difficult or complex claims.

Five years’ experience in a workers’ compensation claims environment which provides the necessary skills, knowledge, and abilities, such as experience in reviewing, investigating, and closing complex workers’ compensation claims.

of handling claims in multiple jurisdictions preferred.

Bilingual skills preferred.

Two years of AF Group Claims Representative II experience that includes discretion in determining compensability of complex claims and/or handling complex, high touch or labor-intensive customers.

• Ability and proficiency in the use of computers and company standard software specific to position.
• Knowledge of medical and legal terminology related to work.
• Knowledge of workers’ compensation laws and regulations, including jurisdictional laws.
• Effective oral and written communication skills.
• Effective customer service skills.
• Ability to negotiate, build consensus and resolve conflict.
• Ability to manage multiple priorities and meet established deadlines.
• Attention to detail and analytical skills.
• Ability to work independently as well as within a team.

• Ability to make independent decisions.
• Ability to solve complex problems.

• Ability to train and mentor others.

Work is performed in an office setting with no unusual hazards.

Minimal travel required.

PAY RANGE: Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors.

It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $56,700 and $94,900.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge, and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer.

Diversity is valued and we will not tolerate discrimination or harassment in any form.

Candidates for the position stated above are hired on an "at will" basis.

Nothing herein is intended to create a contract.

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