Remote Senior Workers' Comp Claims Strategist

EMC Insurance; Florida; Híbrido; USD 79.000 - 120.000; Jornada completa

Descripción de la vacante

EMC Insurance is seeking an experienced workers' compensation claims adjuster to operate primarily from home across Florida, Georgia, North Carolina, or South Carolina. You will oversee moderately to highly complex claims, drive investigations, evaluate coverage and liability, and shape settlement strategies from start to finish.

You will set reserves, explore subrogation opportunities, mentor teammates, and ensure compliance with evolving regulations while maintaining client relationships and

Formación

• Bachelor’s degree or equivalent relevant experience.
• Five years of claims adjusting experience or related experience.
• TPA experience preferred.
• Workers' compensation experience in FL/GA/NC/SC preferred.

Responsabilidades

• Analyze coverage to confirm losses are covered under client policies.
• Initiate contact within 24 hours with clients, claimants, and providers.
• Conduct thorough investigations, including fact-finding and recorded statements.
• Develop and execute action plans to resolve claims efficiently.
• Perform reserve analysis and maintain appropriate reserves.
• Review medical records and bills to assess injury and causation.
• Identify subrogation opportunities and route complex claims for handling.
• Negotiate settlements and manage payments within authority limits.

Conocimientos

Analytical skills

Investigative abilities

Negotiation

Communication skills

Educación

Bachelor’s degree

Herramientas

Claims systems

Descripción del empleo

EMC Insurance is seeking an experienced workers' compensation claims adjuster to operate primarily from home across Florida, Georgia, North Carolina, or South Carolina. You will oversee moderately to highly complex claims, drive investigations, evaluate coverage and liability, and shape settlement strategies from start to finish.

You will set reserves, explore subrogation opportunities, mentor teammates, and ensure compliance with evolving regulations while maintaining client relationships and