Claims Professional Trainee (Spanish Fluency) Details

Claims Professional Trainee (Spanish Fluency)

Berkshire Hathaway Homestate Companies - San Diego, CA

Employment Type : Full-Time

WHO WE AREBerkshire Hathaway Homestate Companies is dedicated to being the best workers compensation insurance company by providing compassionate care to injured workers, superior service to our customers and compelling opportunities for our employees. BHHC has earned an enviable record of success and growth in the insurance industry while growing a culture centered around inclusion and collaboration. We pride ourselves on maintaining our small company feel and recognize that attracting and retaining high quality talent is essential to the success of our company. Come be a part of our growing team!
WHAT WE'RE LOOKING FORAre you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish Speaker looking to apply those skills in a Professional environment? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers’ Compensation Claims Professional.

The Claims Professional Trainee is primarily responsible for the successful completion of the Claims Training program and then successful management of a caseload of workers compensation claims from inception to resolution. Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations. This individual will continue to build on claims knowledge and claims will increase in number and complexity. Responsibilities

• Completes classroom training introducing workers’ compensation claims handling strategies, medical terminology, and legal concepts.
• Learns skills such as investigative and persuasive communication, negotiation, decision-making, and strategic planning. Learns to review and interpret medical records.
• Conducts and directs the investigation of reported claims to determine coverage, compensability and severity and to gather all other relevant information, including making three-point contact telephone calls.
• Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
• Develops and updates a plan of action for the successful resolution of each claim.
• Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently.
• Reduces fraud through early identification and escalation.
• Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.
• Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims.
• Ensures that the actions of all other professionals involved in managing a claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim.

WHAT WILL SET YOU APART

• Minimum of High School Diploma or equivalent certificate required
• Bachelor’s degree from four-year college or university is preferred, but not required
• Ability to communicate effectively verbally and in writing; Spanish Fluency ability preferred
• Exceptional interpersonal and customer service skills
• Ability to manage and prioritize multiple assignments in a fast-paced environment
• Strong organization skills to ensure tasks are completed within hard deadlines
• Basic mathematical skills to calculate monetary reserves
• Knowledge of Microsoft Word, Powerpoint, Excel, Outlook

WHY YOU SHOULD APPLYHealth and Wellness:

• Comprehensive medical plans with low premiums for you and your family
• Dental and vision insurance plans
• Healthcare Flexible Spending Accounts
• Company sponsored life, accidental death and dismemberment, short and long term disability insurance
• Wellness reimbursement for health club memberships and other health and mental wellness activities

Financial:

• 401k plan with employer match
• Paid time off with generous accrual policy
• Commuter benefits
• Tuition reimbursement program to help foster your continued growth
• Employee discounts across Berkshire companies including Geico, See's Candies, etc.

Culture:

• Diverse atmosphere focused on inclusion, transparency and integrity
• Relaxed atmosphere with casual dress code
• Paid volunteer time and office-sponsored volunteer events
• Employee Assistance Program to help with your financial, legal, and personal concerns

Please review our CCPA policies here.
NOTE: BHHC does not conduct interviews via social media (e.g. Google hangout, LinkedIn, etc.). Please be aware that any such contact is fraudulent and we advise that you not provide any personal information. This organization participates in E-Verify. For more information on E-Verify, please contact DHS: 888.897.7781 www.dhs.gov/E-Verify. We will consider for employment-qualified applicants with criminal histories as required by local ordinance. Additionally, no applicant will be denied employment solely on the grounds of conviction of a criminal offense except to the extent necessary to obtain a necessary license or to comply with The Violent Crime Control and Law Enforcement Act of l994, which prohibits the employment by an insurance company of persons convicted of certain crimes, unless a waiver is obtained.