Claims Specialist
The Beacon Mutual Insurance Company
Date: 5 hours ago
City: Warwick, Rhode Island
Contract type: Full time
Job Details
Description
What You’ll Do:
Investigation & Compensability
Conduct thorough investigations and determine compensability on claims with uncertain or questionable factors
Leverage additional investigative resources when needed
Resolution Strategy
Design and implement strategies for optimal claim resolution
Weigh options and consult your manager when necessary to determine the best course of action
Disability & Medical Management
Proactively return injured workers to safe, appropriate work
Ensure medical treatment is appropriate and causally related to the accepted injury
Use your knowledge of medical terminology and procedures to engage resources when necessary
Settlement & Litigation
Evaluate and negotiate moderate dispute claims to settlement
Handle litigated claims with minor issues and consult on litigation strategy as needed
Compliance & Financial Management
Follow Claims Quality Guidelines, handling instructions, and all applicable regulations
Maintain required licenses in good standing
Accurately reserve and issue timely payments, projecting benefits including scarring and loss of use
Consider Medicare and other exposures early in the life of the claim
What You’ll Bring
Bachelor’s degree or 3–5 years of relevant workers’ compensation claims experience
Understanding of WC law, claim procedures, and medical treatment guidelines
Tech-savvy with proficiency in Microsoft Office Suite
Strong communication and decision-making skills
Empathy, professionalism, and a customer-first mindset
Why Work Here
Description
What You’ll Do:
Investigation & Compensability
Conduct thorough investigations and determine compensability on claims with uncertain or questionable factors
Leverage additional investigative resources when needed
Resolution Strategy
Design and implement strategies for optimal claim resolution
Weigh options and consult your manager when necessary to determine the best course of action
Disability & Medical Management
Proactively return injured workers to safe, appropriate work
Ensure medical treatment is appropriate and causally related to the accepted injury
Use your knowledge of medical terminology and procedures to engage resources when necessary
Settlement & Litigation
Evaluate and negotiate moderate dispute claims to settlement
Handle litigated claims with minor issues and consult on litigation strategy as needed
Compliance & Financial Management
Follow Claims Quality Guidelines, handling instructions, and all applicable regulations
Maintain required licenses in good standing
Accurately reserve and issue timely payments, projecting benefits including scarring and loss of use
Consider Medicare and other exposures early in the life of the claim
What You’ll Bring
Bachelor’s degree or 3–5 years of relevant workers’ compensation claims experience
Understanding of WC law, claim procedures, and medical treatment guidelines
Tech-savvy with proficiency in Microsoft Office Suite
Strong communication and decision-making skills
Empathy, professionalism, and a customer-first mindset
Why Work Here
- Competitive Salary along with a broad range of compensation initiatives.
- Comprehensive health plans, life insurance, and wellness programs.
- Generous vacation time, plus telecommuting and flexible schedule options.
- Retirement savings plan and 401(k) educational programs.
- Access to learning and development opportunities for professional growth.
- A friendly and supportive atmosphere where teamwork and knowledge sharing are prioritized.
- Work-family balance supported through flexible arrangements.
- Dedication to the health and wellness of our employees—Beacon is a proud recipient of multiple Worksite Wellness Awards.
- Beacon is an equal opportunity employer. We believe that fostering a lasting culture of inclusion and belonging is the most effective way to attract, develop, and retain a diverse workforce.
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