Remote Claims Specialist II – Workers' Comp

AF Group; Lansing (MI); Remote; USD 57,000 - 95,000; Full time

Job summary

AF Group is seeking an intermediate level claims handler to review and settle workers' compensation claims. You will verify coverage, determine compensability, and assess causal relations to ensure accurate benefit payments.

Responsibilities include managing reserves, negotiating settlements, and coordinating return-to-work while aligning with regulatory requirements and client needs. Remote work options available.

Qualifications

• Bachelor's degree in a related field is required or equivalent experience.
• Three years of workers' compensation claims experience is required.
• Experience handling complex/multi-jurisdictional claims preferred.
• Bilingual skills are preferred.

Responsibilities

• Verifies workers' compensation coverage for employers and injured employees.
• Determines compensability through thorough claim investigations.
• Assesses causal relationship between injury and incident to approve benefits.
• Manages reserves and negotiates settlements within authority.
• Coordinates return-to-work and manages medical bill review for indemnity claims.
• Collaborates with managers on complex files and with outside vendors to contain costs.
• Maintains relationships with internal/external customers and updates on legal changes.

Skills

Negotiation

Communication

Analytical skills

Decision making

Independent work

Team collaboration

Education

Bachelor's degree in related field

Certification encouraged

Continuous learning required

Job description

AF Group is seeking an intermediate level claims handler to review and settle workers' compensation claims. You will verify coverage, determine compensability, and assess causal relations to ensure accurate benefit payments.

Responsibilities include managing reserves, negotiating settlements, and coordinating return-to-work while aligning with regulatory requirements and client needs. Remote work options available.