Senior Claims Specialist
New
J
JobgetherWorkers’ Compensation insurance
Based in the United StatesFull-TimeSenior
Salary29.35 - 47.28 USD per hour
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Job Details
- Experience
- Minimum of 3 years of industry experience and Workers’ Compensation claim-handling experience.
- Required Skills
- Microsoft ExcelMicrosoft Office
Requirements
- Bachelor’s degree or an equivalent combination of education and relevant professional experience.
- Minimum of 3 years of industry experience and Workers’ Compensation claim-handling experience.
- Current state certification or license as an experienced claims adjuster.
- Current Workers’ Compensation license or certification that can be maintained throughout employment.
- Self-Insured Certificate preferred.
- Strong knowledge of Workers’ Compensation claims administration, case management, and cost-containment practices.
- Proficiency with Microsoft Office, including Excel and spreadsheet-based work.
- Strong analytical, problem-solving, and decision-making abilities.
- Strong written and verbal communication, interpersonal, organizational, and time-management skills.
- Ability to manage complex claims independently and collaboratively, using sound judgment and attention to detail.
- Ability to support and coach colleagues by sharing claims knowledge and best practices.
Responsibilities
- Receive and manage Workers’ Compensation claims, confirm policy coverage, and acknowledge claims.
- Investigate claims, determine validity and compensability, gather information, and complete required state documentation.
- Establish claim reserves and authorize payments within designated authority limits.
- Develop and manage action plans with case managers and outcomes managers to reduce claim costs.
- Coordinate early return-to-work initiatives with stakeholders.
- Manage subrogation, litigation, and potential recoveries throughout the claim lifecycle.
- Report claims to excess carriers when applicable and maintain documentation.
- Communicate claim status, decisions, and updates to customers and claimants.
- Follow client, carrier, and state Workers’ Compensation requirements and participate in claims reviews.
- Support colleagues by sharing claims knowledge and practices.
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