Workers' Compensation Specialist
insight globalArlington (VA)
Workers' Compensation Specialist
Posted 6 days ago
insight globalArlington (VA)
SENIORITY
Senior
About the role
Workers’ Compensation Claims Specialist (Remote)
Location: Remote (Central Time Zone Preferred)
Territory:
Indiana, Illinois, Kentucky, and Michigan Start Date: ASAPWe are seeking an experienced Workers’ Compensation Claims Specialist to join a leading third-party claims administration organization. This role is responsible for managing complex, high-exposure workers’ compensation claims while ensuring compliance with applicable state regulations and delivering exceptional client service.
Responsibilities:
Manage a caseload of complex workers’ compensation indemnity claims from inception through resolution.
Determine compensability, benefits eligibility, and appropriate claim strategies within delegated authority levels.
Collaborate with nurse case managers, attorneys, employers, medical providers, and injured workers throughout the claims process.
Investigate claims, evaluate exposures, and develop resolution strategies to achieve optimal outcomes.
Manage subrogation opportunities and negotiate settlements when appropriate.
Maintain accurate claim documentation and ensure compliance with jurisdictional requirements.
Provide timely communication and superior customer service to internal and external stakeholders.
Required Qualifications:
Minimum 3 years of workers’ compensation claims handling experience.
Strong experience managing indemnity claims.
Experience handling claims in at least two of the following jurisdictions:
- Indiana (IN)
- Illinois (IL)
- Kentucky (KY)
- Michigan (MI)
Active workers’ compensation adjuster license in KY, IN, or MI, or a reciprocal license that allows handling claims in these states.
Strong knowledge of workers’ compensation laws, regulations, and claims management practices.
Excellent negotiation, communication, and organizational skills.
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