Remote Workers' Comp Claims Specialist

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

Job summary

Old Republic Commercial Risk in the United States is seeking a Senior Claims professional specializing in Workers' Compensation to independently investigate, evaluate and resolve highly complex claims. You will administer and settle high-risk claims in accordance with statutes, policy provisions, and company guidelines.

Responsibilities include investigating, determining coverage, reserves, subrogation potential, and coordinating with PMA nurses to support return-to-work strategies.

Qualifications

• Bachelor's degree or equivalent work experience in insurance.
• California jurisdiction experience is required.
• Associate in Claims (AIC) or similar designation desired.
• License required or obtainable within 90 days in mandated states.
• Familiarity with workers' compensation regulations and medical terminology.
• Strong organizational and multitasking abilities with detail orientation.

Responsibilities

• Investigate assigned claims with minimal supervision, including complex cases.
• Determine coverage, compensability, and subrogation potential.
• Communicate with clients and stakeholders to provide updates.
• Establish reserves within authority and adjust as needed.
• Negotiate settlements and manage case resolution plans.
• Collaborate with PMA nurses to support return-to-work strategies.

Skills

Claims investigation

Workers' Comp

Negotiation

Subrogation

Communication

MS Office

Education

Bachelor's degree

AIC designation desired

Tools

MS Office

Job description

Old Republic Commercial Risk in the United States is seeking a Senior Claims professional specializing in Workers' Compensation to independently investigate, evaluate and resolve highly complex claims. You will administer and settle high-risk claims in accordance with statutes, policy provisions, and company guidelines.

Responsibilities include investigating, determining coverage, reserves, subrogation potential, and coordinating with PMA nurses to support return-to-work strategies.