Remote Workers' Comp Claims Specialist

AF Group; Richmond (VA); Remote; USD 57,000 - 95,000; Full time

Job summary

AF Group is seeking an intermediate-level workers' compensation claims handler in the Richmond area. You will verify coverage, investigate claims, determine compensability, and facilitate return-to-work while managing reserves and settlements within authority.

Requirements include a bachelor’s degree and 3 years of workers' compensation experience. Strong communication, negotiation, and analytical skills are essential to success in this role at AF Group.

Qualifications

• Bachelor's degree in a related field.
• Three (3) years of experience in a workers' compensation claims environment.
• Continuous learning as defined by the Company's philosophy is required.
• Certification or progress toward certification is highly preferred and encouraged.
• One (1) year of AF Group Claims Representative I experience handling difficult or complex claims.

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 injury and incident for proper benefits.
• Facilitates return to work for the injured employee.
• Establishes timely reserves within authority based on expected exposure.
• Documents specifics of claims with potential for subrogation recovery.
• Manages medical bills for indemnity and non-indemnity claims.
• Approves payments based on treatment plans and medical support.
• Closes files after resolution while complying with state laws and internal standards.
• Negotiates settlements with attorneys or injured parties within authority.
• Works with manager on complex files above settlement/reserve authority.
• Manages outside vendors for cost containment.
• Maintains relationships with internal and external customers.
• Keeps abreast of workers' comp statutes and case law.

Skills

Communication skills

Negotiation

Independent decision making

Multitasking

Attention to detail

Analytical skills

Teamwork

Education

Bachelor's degree

Job description

AF Group is seeking an intermediate-level workers' compensation claims handler in the Richmond area. You will verify coverage, investigate claims, determine compensability, and facilitate return-to-work while managing reserves and settlements within authority.

Requirements include a bachelor’s degree and 3 years of workers' compensation experience. Strong communication, negotiation, and analytical skills are essential to success in this role at AF Group.