Remote Senior Workers' Comp Claims Specialist

AF Group; Chicago (IL); Remote; USD 57,000 - 95,000; Full time

Benefits offered by this job

Remote work option

Job summary

AF Group is seeking an intermediate level Workers' Compensation Claim Handler to assess, investigate, and settle moderate to difficult claims. You will verify coverage, determine eligibility, and establish reserves within authority while coordinating return‑to‑work efforts and managing medical expenses.

Ideal candidates have at least 3 years' WC claims experience, strong negotiation and communication skills, and the ability to handle claims across multiple jurisdictions.

Qualifications

• Three (3) years of experience in a workers' compensation claims environment.
• Experience handling claims in multiple jurisdictions preferred.
• Bilingual skills preferred.

Responsibilities

• 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 the profile of the claim within given authority.
• Documents specifics of claims with potential for subrogation recovery.
• Manages medical bills for non-indemnity and indemnity claims.
• Approves payment based on knowledge of treatment plans.
• Concludes and closes files after resolution to meet performance standards.
• Negotiates settlements with attorneys or injured parties within authority.
• Works with manager on complex files.
• Manages outside vendors to contain costs.
• Maintains effective relationships with internal and external customers.
• Stays abreast of changes in workers' compensation statutes.

Skills

Negotiation

Analytical skills

Communication skills

Multitasking

Education

Bachelor's degree in a related field

Job description

AF Group is seeking an intermediate level Workers' Compensation Claim Handler to assess, investigate, and settle moderate to difficult claims. You will verify coverage, determine eligibility, and establish reserves within authority while coordinating return‑to‑work efforts and managing medical expenses.

Ideal candidates have at least 3 years' WC claims experience, strong negotiation and communication skills, and the ability to handle claims across multiple jurisdictions.