Senior Claims Specialist – Workers Compensation

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

📋 Description

• Oversee workers' compensation claims for Pennsylvania and Delaware from initiation to closure.

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

• Formulate and implement strategies to secure timely and positive outcomes for claims.

• Set and uphold appropriate reserves for claims.

• Negotiate settlements to facilitate claim resolution.

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

• Prepare and deliver large loss reports to both internal and external audiences.

• Work in collaboration with defense attorneys on litigation strategies and resolution of claims.

• Partner with medical case managers, surveillance vendors, and other external resources.

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

• Keep accurate and up-to-date documentation for claims.

• Analyze trends in claims and exposures to aid in effective decision-making.

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

⛳️ Requirements

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

• Comprehensive knowledge of workers' compensation laws, regulations, and claims practices in Pennsylvania and Delaware.

• Professional designations, such as Associate in Claims (AIC), are preferred.

• Availability to work during Eastern Time Zone business hours.

• Willingness to travel occasionally as required.

• Excellent written and verbal communication skills.

• Ability to collaborate with a diverse range of internal and external contacts.

• A Delaware workers’ compensation license is mandatory.

• Additional state licenses are advantageous.

• Must have authorization to work in the United States without 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.