All roles

Workers Comp Claims Specialist

Remote · USA Full-time New today

Job Description:

  • Manages a large inventory of complex claims to evaluate compensability/liability.
  • Plans and conducts complex claims investigations to confirm coverage and to determine liability, compensability and damages.
  • Analyzes and negotiates appropriate claim settlements/reserves within prescribed authority.
  • May attend arbitrations, mediations, depositions, or trials.
  • Conveys complex information regarding coverage and settlements to insureds, claimants, and external partners.
  • Authorizes payments in accordance with assigned authority limit and ensures payments are made in a timely manner.
  • Maintains accurate and detailed claim files, including all correspondence, reports, and settlement agreements.
  • May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports.

Requirements:

  • Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience
  • Generally, a minimum of 9 years of experience in property and casualty claims handling
  • Completion of or continuing progress toward a professional designation preferred, such as Associate in Claims (AIC)
  • Works within broad limits and authority on assignments of the highest technical complexity, requiring specialized knowledge.
  • Demonstrates excellent analytical, negotiation, and problem-solving skills.
  • Maintains strong knowledge of insurance policies, coverage, and claims handling procedures.
  • Maintains knowledge of industry laws and regulations.
  • Advanced ability to organize and prioritize caseloads, ensuring timely resolution of claims.
  • Proven ability to handle confidential information with discretion.

Benefits:

  • medical, dental, and vision coverage
  • wellness plans
  • parental leave
  • adoption assistance
  • tuition reimbursement
  • Paid Time Off
  • paid holidays
  • 401(k) plan with company match
  • employee stock purchase plan
  • commuter benefits

Apply tot his job Apply To this Job

Related roles

Operations Analyst, Workforce Management & Planning

Remote · USA Full-time

Senior Manager, Workforce Management, Quality

Remote · USA Full-time

Clinical Psychologist - PSYPACT (Telehealth)

Remote · USA Full-time

DSHS HCLA LMS and E-Learning Administrator

Remote · USA Full-time

Case Manager - Behavioral Health

Remote · USA Full-time

LMS Administrator II

Remote · USA Full-time

Facility Compliance Consultant (Nursing Home Surveyor

Remote · USA Full-time

Social Worker, MSW, Full Time

Remote · USA Full-time

MLTC Social Work Care Manager/ Remote

Remote · USA Full-time

Remote Psychologist Assistant

Remote · USA Full-time

⭐Immediate Hiring: Remote Entry-Level Position | Flexible Hours | No Experience Needed

Remote · USA Full-time

Clinical Quality Assurance Coordinator (RN, LPN, LVN) (31899)

Remote · USA Full-time

Experienced Full Stack Software Engineer – Customer Identity and Digital Product Development at arenaflex

Remote · USA Full-time

Experienced Customer Service Representative – Remote Opportunity at arenaflex

Remote · USA Full-time

UI/UX Designer

Remote · USA Full-time

Experienced Customer Support Specialist – Remote Work Opportunity at arenaflex

Remote · USA Full-time

Intake Specialist/ Prior Authorization Specialist

Remote · USA Full-time

Experienced Customer Experience Expert – Coordinator, Complaint & Appeals in Healthcare

Remote · USA Full-time

Brand and Operations Officer

Remote · USA Full-time

Medical Science Liaison North

Remote · USA Full-time