Senior Claim Representative I

<strong>AF Group (Lansing, Mich.) and its subsidiaries are a premier provider of innovative insurance solutions. Insurance policies may be issued by any of the following companies within AF Group: Accident Fund Insurance Company of America, Accident Fund National Insurance Company, Accident Fund General Insurance Company, United Wisconsin Insurance Company, Third Coast Insurance Company, or CompWest Insurance Company.</strong>

United States, USA

AF Group

<p class="p1"><strong>AF Group&rsquo;s focused and passionate team uses industry-leading best practices, analytics and resources to manage risk and minimize loss for our policyholders while strengthening businesses with our valued independent agent partners.</strong></p> <p class="p1"><strong>We strive to continuously increase the long-term value of our organization by outperforming our industry peers and fostering a culture of underwriting and claims excellence.</strong></p>

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Competitive Compensation and Benefits Package

Overview: This position serves as a technical expert in the claim handler career path. Under limited supervision, handles claims with litigation, complex/catastrophic, and/or coverage elements. Handles the most unique cases, where little precedence has been established. May handle the most complex, high touch, or labor-intensive customers. Serves as a department leader by developing other employees and may function as acting manager in the absence of department management.
Responsibilities: <br /> <ul> <li>Independently administers complex claims and catastrophic exposures within the authority, including claims from dedicated large accounts.</li> <li>Establishes timely and appropriate reserves based on claim profile and anticipated financial exposure.</li> <li>Represents the Company by working closely with customers, agents, and brokers to resolve the most complex claim issues.</li> <li>Negotiates settlements with attorneys or injured and exercises independent judgment to settle cases prior to mediation or litigation.</li> <li>Manages outside vendors to ensure cost containment efforts.</li> <li>Establishes and maintains effective working relationships with all internal and external customers.</li> <li>Stays abreast of changes in workers&rsquo; compensation statutes, case law, and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.</li> <li>Actively participates in agent/client relationship management.&nbsp;</li> <li>Mentors team members.</li> <li>May serve as department leader in the absence of management or act as manager designee.</li> </ul>
Requirements: <p><strong>EDUCATION OR EQUIVALENT EXPERIENCE:</strong></p> <p>Bachelor&rsquo;s degree in a related field. A relevant combination of education and experience may be considered in lieu of a degree.&nbsp; Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.&nbsp; Certification or progress toward certification is highly preferred and encouraged.<br /><br /><br /><strong>EXPERIENCE:<br /><br /></strong>Seven years of progressively more responsible experience in a workers&rsquo; compensation claims environment that provides the necessary skills, knowledge, and abilities, such as experience in reviewing, investigating, and closing the most complex workers&rsquo; compensation claims.&nbsp; Experience handling claims in multiple jurisdictions preferred.&nbsp; Bilingual skills preferred.&nbsp;</p> <p>OR</p> <p>Two years of AF Group Claims Representative III experience that includes independent handling of the most complex claims and/or the most complex, high touch, or labor-intensive customers.<br /><br /><br /></p> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Ability and proficiency in the use of computers and company standard software specific to position.</li> <li>Knowledge of medical and legal terminology related to the work.</li> <li>Knowledge of workers&rsquo; compensation laws and regulations, including jurisdictional laws.</li> <li>Effective oral and written communication skills.</li> <li>Effective customer service skills.</li> <li>Ability to negotiate, build consensus and resolve conflict.</li> <li>Ability to act as a representative of the Company and establish effective working relationships.</li> <li>Ability to manage multiple priorities and meet established deadlines.</li> <li>Attention to detail and analytical skills.</li> <li>Ability to make independent decisions.</li> <li>Ability to solve highly complex problems.</li> <li>Ability to train and mentor others.</li> <li>Ability to lead others.</li> </ul>