Complex Workers' Compensation Claims Specialist (Western USA)

h3Description /h3 pBerkshire Hathaway Direct Insurance Company (BHDIC) is the home of commercial small business insurance products biBerk Business Insurance and THREE by Berkshire Hathaway. Our Claims Department is looking for an experienced claims specialist with a strong background in complex Workers’ Compensation claims. This role handles a caseload of highly complex/high‑severity Workers’ Compensation claims and requires a comprehensive knowledge of Workers’ compensation regulations, laws, and best practices. This role will report to the Workers’ Compensation Complex Claims Team Lead. Multi‑state experience handling Workers’ Compensation claims in the following jurisdictions is preferred: California, Arizona, Colorado. /p h3Job Type /h3 pFull‑time /p h3Description /h3 pBerkshire Hathaway Direct Insurance Company (BHDIC) is the home of commercial small business insurance products biBerk Business Insurance and THREE by Berkshire Hathaway. Our Claims Department is looking for an experienced claims specialist with a strong background in complex Workers’ Compensation claims. This role handles a caseload of highly complex/high‑severity Workers’ Compensation claims and requires a comprehensive knowledge of Workers’ compensation regulations, laws, and best practices. This role will report to the Workers’ Compensation Complex Claims Team Lead. Multi‑state experience handling Workers’ Compensation claims in the following jurisdictions is preferred: California, Arizona, Colorado. Location: This is a full‑time remote position. This position may require occasional travel to attend mediations, trainings, and/or other related department meetings. /p h3Job Responsibilities /h3 pThe Complex Claims Specialist will be responsible for, but not limited to: /p ulliInvestigate coverage, determine compensability, and manage a pending of high exposure Workers’ Compensation claims involving catastrophic injuries and complex cases /liliProactively establish and update reserves throughout the life of the claim to reflect claim exposure and document supporting rationale /liliResolve claims within authority and make independent case value recommendations to senior leadership on cases which exceed authority /liliParticipate in reserving, pricing and strategy discussions with senior leadership /liliCollaborate with outside defense counsel to effectively manage litigated files according to established litigation management guidelines /liliPartner with medical providers, customers, and injured workers to facilitate appropriate medical treatment and ensure timely submission of medical bills /liliEnsure compliance with state and federal Workers’ Compensation regulations /liliProvide exceptional customer service to policyholders, agents, injured workers, medical providers, legal, and vendors /liliFollow escalation and reporting requirements on claims with significant exposure /liliDevelop creative resolution strategies to manage losses involving complex issues, effectively utilizing appropriate internal and external resources /liliDocument claim files in accordance with company and regulatory guidelines /liliIdentify subrogation potential and red flags that require SIU involvement /liliTrain new team members /liliAct as a technical resource to less experienced claims representatives /liliMaintain continuing education requirements /li /ul h3Requirements /h3 h3Qualifications /h3 h3Knowledge And Experience /h3 ulliActive adjuster license required or SIP /lili10+ years of experience handling complex workers’ compensation claims /liliExcellent organizational, leadership, communication and time management skills /liliExperience with structured settlements and Medicare Set-Asides /liliAbility to work in a fast‑paced, collaborative, virtual office environment /liliStrong analytical, organizational, and time management skills /liliExcellent written and verbal communication skills /liliAbility to work independently and meet assigned deadlines /liliStrong negotiation skills /liliAbility to multi-task and effectively prioritize tasks with frequent interruptions /liliProficiency with MS Word, Excel and internet applications /liliHighly attentive to details /liliAble to work under pressure and execute good judgment in sensitive situations /liliAdvanced verbal and written communication skills are essential for interacting with internal and external stakeholders /li /ul h3Education /h3 ulliBA/BS degree required /liliAIC, SCLA, CPCU or other industry designation a plus /li /ul h3About Us /h3 pbiBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBerk.com will be underwritten by Berkshire Hathaway Direct Insurance Company ("BHDIC"), which is an AM Best rated A++ insurer. /p pBHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBerk are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust. /p pBHDIC is excited to announce our comprehensive benefits package with some new and enhanced features for 2026 that include: /p ulliMedical (PPO/HDHP), vision, disability, and life insurance. /liliEnhanced dental plan with orthodontia coverage in addition to a standard plan. /liliGenerous PTO plan for all benefit-time eligible employees. /liliPaid company holidays and 4 floating holidays. /liliPaid parental leave. /liliEmployee Retirement Savings Plan/401(k) with company match and immediate vesting. /liliEducation Assistance Program that offers 100% upfront tuition reimbursement after 6 months of service for approved degree programs. /liliService Recognition Program that provides a monetary award to be used toward a vacation every 5 years of employment. /liliWellness Initiatives that include Fitness Center and Weight Watchers Reimbursement programs. /liliVoluntary benefits that include accident, critical illness, and hospital indemnity. /liliEmployee discount and rewards program on travel, tickets, electronics, home, and more. /li /ul pIn accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided. The salary range for this position is b$100,000 - $125,000 per year. /b Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law. /p #J-18808-Ljbffr