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Senior Workers' Compensation Claims Specialist | Remote
3 weeks ago
Our client, a respected leader within the insurance sector, is seeking a Senior Workers' Compensation Claims Specialist to join their growing team. The ideal candidate will have a demonstrated ability to manage moderate to complex Pennsylvania and New Jersey Workers' Compensation Lost Time claims while maintaining a strong commitment to accuracy, timeliness, and exceptional service. This position offers remote flexibility, though candidates should be based in Pennsylvania.
Key Responsibilities
- Oversee the full life cycle of PA and NJ Workers' Compensation claims from first notice of loss through resolution and settlement.
- Manage a pending of 115 - 125 files; negotiate settlements and approve payments within designated authority levels.
- Ensure strict compliance with state regulations and internal claims procedures.
- Collaborate with policyholders, attorneys, medical providers, and employers to secure needed documentation and facilitate claim resolutions.
- Maintain thorough claim files and prepare timely status and progress reports for management.
- Participate in hearings, mediations, and related legal proceedings when necessary.
- Serve as a resource and mentor for junior examiners, offering technical support and guidance.
- 3 - 7+ years of experience handling workers' compensation claims with solid knowledge of PA and NJ regulations.
- Insurance carrier or TPA experience required.
- Active Adjuster License preferred.
- Strong organizational, analytical, and communication skills with the ability to manage tasks independently.
- Bachelor's degree in Business, Insurance, or a related discipline preferred.
- Competitive base salary of $85,000 - $105,000+ with annual bonus potential.
- 401(k) with employer match.
- Comprehensive medical, dental, vision, and life insurance coverage.
- Employer contribution toward HSA.
- Generous PTO and flexible scheduling.
- Remote work option for qualified candidates.
