Remote Senior Workers' Comp Claims Investigator

Old Republic Commercial Risk; San Francisco (CA); On-site; USD 70,000 - 85,000; Full time

Job summary

Old Republic Commercial Risk is seeking a qualified Claims professional to independently investigate, evaluate, and resolve complex Workers' Compensation claims in a remote position. Responsibilities include determining coverage, negotiating settlements, and coordinating return-to-work plans with PMA nurses.

Requirements include a Bachelor's degree or 4+ years in insurance, California jurisdiction experience, and licensure within 90 days.

Qualifications

• Bachelor's degree or equivalent insurance experience.
• California jurisdiction experience preferred.
• Licensing within 90 days of employment required in mandated states.

Responsibilities

• Investigate complex Workers' Compensation claims with minimal supervision.
• Assess coverage, compensability, and subrogation potential.
• Manage reserves with documented rationale and adjust over time.
• Negotiate settlements within authority and communicate decisions clearly.
• Coordinate return to work strategies with PMA nurses.
• Select and manage service vendors to balance cost and outcomes.
• Provide high levels of customer service during reviews and meetings.

Skills

Strong organizational skills

Strong verbal and written comunicação

Attention to detail

Customer service

MS Office (Word, Excel, PowerPoint)

Education

Bachelor's degree or 4+ years insurance experience

Associate in Claims (AIC) designation preferred

Tools

MS Office Suite

Job description

Old Republic Commercial Risk is seeking a qualified Claims professional to independently investigate, evaluate, and resolve complex Workers' Compensation claims in a remote position. Responsibilities include determining coverage, negotiating settlements, and coordinating return-to-work plans with PMA nurses.

Requirements include a Bachelor's degree or 4+ years in insurance, California jurisdiction experience, and licensure within 90 days.