Workers' Compensation Specialist

Title: Workers' Compensation Specialist

Location: Jersey City, NJ (HQ)

Job Description:

time type

Full time

job requisition id

JR-33

AEGIS Insurance Services Inc. has an immediate opening for:

Workers' Compensation Specialist

Job Description:

AEGIS Insurance Services, Inc. (“AEGIS”) has an immediate opening for a Workers’ Compensation Specialist who will be responsible for overseeing an inventory of complex Workers’ Compensation claims at the excess level, managed by third party administrators and self-insureds at the primary level. Effectively manage assigned claims and provide appropriate advice to AEGIS and its Members relative to excess Workers’ Compensation matters.

Job Purpose:

Responsible for overseeing an inventory of complex Workers’ Compensation claims at the excess level, managed by third party administrators and self-insureds at the primary level. Effectively manage assigned claims and provide appropriate advice to AEGIS and its Members relative to excess Workers’ Compensation matters.

Job Requirements:

• Minimum 3 years of relevant work experience with a carrier, third party administrator, or self-insured

• Current experience should involve direct management of active Workers’ Compensation claims

• Experience managing Workers’ Compensation claims across multiple jurisdictions a plus

• Undergraduate degree or equivalent work experience

• CWCP or equivalent Workers’ Compensation education or designations a plus

• Applied knowledge of Workers’ Compensation claims, medical management procedures, medical cost containment programs and applicable laws and regulations

• Proficiency with Microsoft Office: Specifically Word, Excel, and PowerPoint

• Ability to effectively present to varied audiences

• Ability to effectively negotiate large and/or complex claims

AEGIS Core Competencies:

• Collaborative Communications and Behavior: 0Develops and maintains effective working relationships as a team member and across divisions; readily collaborates and shares information, seeks and provides constructive feedback, and supports a respectful workplace. 

• Initiative and Accountability: Proactively addresses opportunities to enhance AEGIS’ people, processes, products, and services, takes ownership for one’s responsibilities by acting with integrity and in the best interest of the organization and stakeholders.

• Quality-Focused: Demonstrates a solution-focus, displays thoroughness and accuracy through quality deliverables, and demonstrates persistence and perseverance in achieving concrete and tangible outcomes.

• Service-Oriented: Conveys a genuine desire and ability to anticipate and meet customer needs and creates and nurtures mutually beneficial relationships within AEGIS and with AEGIS Members and brokers

Essential Job Functions:

Quality Assurance and Continuous Improvement

• Achieve timely and proper coverage analysis and verification, and communicate AEGIS’ coverage positions on assigned claims

• Achieve timely, adequate, and accurate factual investigation of issues of compensability, subrogation and offset potential

• Achieve timely and accurate evaluation of compensability

• Achieve timely and adequate establishment of indemnity, medical and expense reserves (UNL and NUNL) reflecting AEGIS’ ultimate probable cost/exposure

• Achieve timely and appropriate reporting to file, claims management and reinsurers, as needed

• Keep abreast of developments in the law and their applicability and impact on AEGIS claims

• Assist in the administration of the Workers’ Compensation Claim Review program

Account Management

• Monitor “long-tail” exposure claims to ensure recognition of AEGIS exposure and appropriate reserving

• Provide timely advice, technical assistance and case management direction to insureds’ claim professionals and defense attorneys in the investigation, evaluation, negotiation, settlement and defense of claims and litigation, as appropriate

• Conduct or participate in settlement negotiations in conjunction with insured’s personnel and counsel, when appropriate

• Consult with Claims management and the Claims Review Committee, as required, in the evaluation and management of assigned claims

• As directed, provide advice and guidance to other claims professionals within the Claims Division in the evaluation and management of claims, analysis of coverage issues and in the research and review of the various state and federal Workers’ Compensation statutes

• Ensure the smooth operation of the Workers’ Compensation Department when Claims management team is unavailable

Collaboration and Team Support

• Assist in the development of policy and standards for the Claims Division

• Foster and maintain good relationships with insureds, third party administrators, brokers and counsel

EOE

AEGIS Insurance Services, Inc. participates in E-Verify

We expect to pay a starting salary between $95,000 and $105,000. An applicant’s placement within this range is based on their individual qualifications and professional experience. In addition to base salary, AEGIS employees are eligible to participate in the Company’s annual incentive program, with competitive awards based on corporate and individual performance.

In addition, we offer a comprehensive and competitive suite of options for health & wellness, retirement, income protection, time off and additional benefits:

• Health & Wellness: Medical, dental, vision, mental health support and employee assistance programs

• Retirement: 401(k) with matching contribution

• Income Protection: Life, disability, accident and critical illness insurance

• Time Off: Vacation days, sick days, holidays and family/military leave options

• Other: Commuter benefits, pet insurance, hybrid work schedule

• Growth: Tuition assistance and professional development opportunities

In addition, we offer a comprehensive and competitive suite of options for health & wellness, retirement, income protection, time off and additional benefits:

• Health & Wellness: Medical, dental, vision, mental health support and employee assistance programs

• Retirement: 401(k) with matching contribution

• Income Protection: Life, disability, accident and critical illness insurance

• Time Off: Vacation days, sick days, holidays and family/military leave options

• Other: Commuter benefits, pet insurance, hybrid work schedule

• Growth: Tuition assistance and professional development opportunities

We will consider this application carefully, but it does not guarantee employment.  Selection is on a competitive basis.  In addition, you must meet employment standards and specific position requirements.  Qualified applicants will receive consideration for employment without regard to race, creed, color, sex, sexual orientation, age, marital status, disability, national origin, veteran status or any other legally protected status.

AEGIS Insurance Services, Inc. participates in E-Verify.