Remote Workers' Comp Claims Specialist

PMA Companies; Plano (TX); Remote; USD 60,000 - 90,000; Full time

Job summary

PMA Companies is seeking a Claims Specialist to independently investigate, evaluate, and resolve complex workers' compensation claims. The role requires understanding of coverage, subrogation, reserving, and settlements, with collaboration across medical and legal stakeholders.

TX experience and licensure within 90 days are preferred. The position supports remote work and requires strong communication and organizational skills to manage multiple claims effectively.

Qualifications

• Bachelor's degree and/or four or more years of equivalent work experience in an insurance-related industry.
• TX experience is required.
• AIC designation or similar is desirable.

Responsibilities

• Investigates assigned claims with minimal supervision, including complex ones.
• Determines coverage, compensability, and potential subrogation.
• Negotiates settlements within authority and documents rationale.
• Manages Reserve levels and adjusts as exposure changes.
• Collaborates with PMA nurses to support return-to-work strategies.
• Works with service vendors to balance costs and losses.
• Maintains knowledge of state laws and jurisdictional requirements.

Skills

Analytical thinking

Communication skills

Customer service

Education

Bachelor's degree or 4+ years in insurance

AIC designation (or similar)

Tools

MS Office

Excel

Word

Job description

PMA Companies is seeking a Claims Specialist to independently investigate, evaluate, and resolve complex workers' compensation claims. The role requires understanding of coverage, subrogation, reserving, and settlements, with collaboration across medical and legal stakeholders.

TX experience and licensure within 90 days are preferred. The position supports remote work and requires strong communication and organizational skills to manage multiple claims effectively.