Workers' Compensation Claims Specialist – Alternative Markets

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

📋 Description

• Oversee a substantial inventory of claims, which includes medical only, indemnity, and potential CAT.

• Organize and execute intricate claims investigations to verify coverage, causal relationships, and compliance with state benefit laws.

• Evaluate and negotiate suitable claim settlements and reserves within established authority limits.

• Participate in arbitrations, mediations, depositions, or trials as required.

• Approve payments within designated authority limits and ensure their prompt processing.

• Keep precise and comprehensive claim files, encompassing correspondence, reports, and settlement agreements.

• Potentially supervise staff performance and provide coaching.

• Engage in talent acquisition, development, and performance evaluation decisions for direct reports.

• Carry out other assigned responsibilities.

⛳️ Requirements

• Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field, or equivalent experience.

• Typically, 5 or more years of experience in handling workers' compensation claims.

• Completion of or ongoing progress toward a professional designation is preferred, such as Associate in Claims (AIC).

• Specialized understanding of insurance policies, coverage, and claims handling processes.

• Familiarity with industry laws and regulations.

• Advanced capability to organize and prioritize caseloads effectively.

• Exceptional analytical, negotiation, and problem-solving abilities.

• Strong interpersonal and communication skills.

• Capacity to build relationships and lead negotiations successfully.

• Demonstrated ability to manage confidential information with care.

• Must possess authorization to work in the United States without the necessity for 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.