Remote Senior Workers’ Comp Claim Specialist (CA)

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

Job summary

AF Group is seeking an intermediate-level workers' compensation claims professional to handle moderate to difficult claims from a remote US location. The role requires knowledge of California claims jurisdiction, though residency in California is not required.

You will verify coverage, determine compensability, assess causality, and manage reserves and medical bills while coordinating settlements within authority and mentoring junior staff.

Qualifications

• Bachelor's degree in a related field or equivalent combination of education and experience.
• 3 years of workers' compensation claims experience required; multi-jurisdiction experience preferred.
• Ability to review, investigate, and close workers' compensation claims; bilingual skills preferred.

Responsibilities

• Verifies workers' compensation coverage for employers and injured employees.
• Determines compensability under workers' compensation by thorough investigation.
• Assesses causal relationship to ensure appropriate payment of benefits.
• Facilitates return to work for the injured employee.
• Establishes reserves within authority based on anticipated financial exposure.
• Manages medical bills for indemnity and non-indemnity claims.

Skills

Negotiation

Oral & written communication

Analytical thinking

Customer service

Decision making

Education

Bachelor's degree in related field

Job description

AF Group is seeking an intermediate-level workers' compensation claims professional to handle moderate to difficult claims from a remote US location. The role requires knowledge of California claims jurisdiction, though residency in California is not required.

You will verify coverage, determine compensability, assess causality, and manage reserves and medical bills while coordinating settlements within authority and mentoring junior staff.