Workers Compensation Claims Specialist, West

$49,000 - $98,000/Yr

C.N.A Insurance Companies - Brea, CA

Full-time - Mid Level

Brea, CA

Insurance Carriers and Related Activities

About the position

The Workers Compensation Claims Specialist at CNA Insurance is an individual contributor role responsible for managing commercial claims of moderate to high complexity. This position involves investigating and resolving claims while ensuring compliance with company protocols and quality standards. The specialist will interact regularly with customers and insureds, providing exceptional service and maintaining effective communication throughout the claims process.

Responsibilities

• Manage an inventory of moderate to high complexity commercial claims by verifying policy coverage and conducting investigations.
• Provide exceptional customer service by interacting professionally with insureds, claimants, and business partners.
• Verify coverage and establish timely reserves by reviewing policy language and estimating potential claim valuation.
• Conduct focused investigations to determine compensability, liability, and covered damages by gathering pertinent information.
• Establish and maintain working relationships with internal and external partners to effectively resolve claims.
• Authorize claim disbursements within authority limits by determining liability and negotiating settlements.
• Contribute to expense management by resolving claims timely and accurately, ensuring high-quality service.
• Identify and address subrogation/salvage opportunities or potential fraud occurrences.
• Achieve quality standards on every file by following company guidelines and ensuring proper documentation.
• Maintain compliance with state/local regulatory requirements and stay current on commercial insurance laws.

Requirements

• Bachelor's Degree or equivalent experience.
• Typically a minimum of four years of relevant experience in claim handling.
• Solid working knowledge of the commercial insurance industry, products, policy language, coverage, and claim practices.
• Strong verbal and written communication skills to develop positive working relationships and present information effectively.
• Demonstrated ability to develop collaborative business relationships with internal and external partners.
• Ability to exercise independent judgment and solve moderately complex problems.
• Demonstrated investigative experience with analytical mindset and critical thinking skills.
• Strong work ethic with time management and organizational skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Knowledge of Microsoft Office Suite and ability to learn business-related software.

Nice-to-haves

• Professional designations such as CPCU are a plus.
• Experience in negotiating low to moderately complex settlements.

Benefits

• Comprehensive and competitive benefits package including physical, financial, emotional, and social wellbeing support.