Hybrid WC Claims Resolution Specialist

Amerisure Insurance; Charlotte (NC); Hybrid; USD 70,000 - 95,000; Full time

Job summary

Amerisure is seeking a WC Claims Resolution Specialist – Special Risk Policyholders in a hybrid role with in-office presence two days a week. The candidate will manage workers’ compensation claims for insureds in loss-sensitive programs, conduct thorough investigations, and drive settlements with strong negotiation and analytical skills.

Ideal candidate has a bachelor’s degree and 5 years of WC claims experience, with the ability to obtain state licensing and travel up to 15%.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 5 years of experience handling workers’ compensation claims of medium to high level of severity/complexity.
• Ability to obtain appropriate state licensing as required.
• Proficient computer skills including Microsoft Office Suite.
• Strong analytical skills and attention to detail.
• Excellent verbal and written communication skills.
• Ability to travel overnight up to 15%.

Responsibilities

• Investigate losses, determine coverage, assess compensability, and review and analyze documents and pleadings.
• Collaborate with legal counsel to manage litigated claims and analyze documents and proceedings.
• Develop and execute proactive claim resolution strategies, including timely evaluations, negotiations, and settlements.
• Establish and maintain accurate claim reserves reflecting financial exposure and communicate rationale to insured.
• Identify external resources to facilitate proper resolutions while controlling costs.
• Partner with insureds, medical providers, and injured workers to facilitate safe return to work when appropriate.
• Collaborate with agents, policyholders, and internal stakeholders to analyze claims trends and provide education.
• Prepare and deliver detailed claim summaries and reserve updates.
• Understand loss-sensitive programs and keep insured informed of financial implications.
• Mentor and train other claims handlers.

Skills

Claims handling

Negotiation

Analytical skills

Communication

Licensing eligibility

Travel up to 15%

Education

Bachelor’s degree or equivalent

Tools

Microsoft Office

Job description

Amerisure is seeking a WC Claims Resolution Specialist – Special Risk Policyholders in a hybrid role with in-office presence two days a week. The candidate will manage workers’ compensation claims for insureds in loss-sensitive programs, conduct thorough investigations, and drive settlements with strong negotiation and analytical skills.

Ideal candidate has a bachelor’s degree and 5 years of WC claims experience, with the ability to obtain state licensing and travel up to 15%.