Claims Specialist II — Workers’ Comp & Settlements

AF Group; Philadelphia (Philadelphia County); À distance; USD 57 000 - 95 000; Plein temps

Résumé du poste

AF Group seeks a Claim Representative II to handle moderately difficult workers' compensation claims in the Philadelphia area. You will determine compensability, assess causal relationships, and negotiate settlements within your authority.

The role requires a Bachelor's degree or equivalent experience, three years in WC claims, and strong communication and analytical skills. Bilingual ability is preferred; travel is minimal, and cost containment is emphasized.

Qualifications

• Bachelor's degree or equivalent experience.
• Three years' experience in a workers' compensation claims environment.
• Bilingual skills preferred.
• Experience handling claims across multiple jurisdictions preferred.

Responsabilités

• Verifies workers' compensation coverage of employers and injured employees.
• Determines compensability under workers' compensation by thorough investigation of the claim.
• Determines causal relationship between the injury and incident to ensure appropriate payment of benefits.
• Facilitates return to work for the injured employee.
• Establishes timely reserves based on claim profile within authority.
• Documents claim details with potential subrogation recovery.

Connaissances

Computer literacy

Communication skills

Negotiation

Multitasking

Attention to detail

Teamwork

Formation

Bachelor's degree or equivalent

Description du poste

AF Group seeks a Claim Representative II to handle moderately difficult workers' compensation claims in the Philadelphia area. You will determine compensability, assess causal relationships, and negotiate settlements within your authority.

The role requires a Bachelor's degree or equivalent experience, three years in WC claims, and strong communication and analytical skills. Bilingual ability is preferred; travel is minimal, and cost containment is emphasized.