Senior Claims Specialist – Workers Compensation

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Oversee workers' compensation claims in Pennsylvania and Delaware from start to finish.

• Assess claim details and determine coverage, compensability, and eligibility for benefits.

• Formulate and implement strategies to ensure prompt and favorable outcomes for claims.

• Set and maintain appropriate reserves for each claim.

• Negotiate settlements to achieve resolution of claims.

• Maintain regular communication with claimants, insured parties, employers, and other involved stakeholders.

• Prepare and deliver reports on significant losses to both internal and external audiences.

• Work closely with defense counsel on strategies for litigation and claim resolution.

• Collaborate with medical case managers, surveillance vendors, and various external resources.

• Ensure adherence to the workers' compensation laws and regulations of Illinois.

• Keep claim documentation accurate and up-to-date.

• Analyze trends in claims and exposure to facilitate sound decision-making.

• Deliver outstanding service while fostering strong relationships with customers and business partners.

⛳️ Requirements

• A minimum of 10 years of experience in adjusting workers' compensation claims for Pennsylvania and Delaware, particularly with complex or high-exposure claims.

• In-depth understanding of workers' compensation laws, regulations, and claims practices in Pennsylvania and Delaware.

• Possession of professional industry designations, such as Associate in Claims (AIC), is preferred.

• Ability to work during Eastern Time Zone business hours and travel occasionally as necessary.

• Exceptional written and verbal communication skills.

• Capability to interact with a diverse range of internal and external stakeholders.

• A Delaware workers’ compensation license is mandatory.

• Additional licenses from other states are advantageous.

• Candidates must be authorized to work in the United States without requiring current or future sponsorship.

🏝️ Benefits

• Medical coverage

• Dental coverage

• 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