Remote Workers’ Comp Claims Specialist (CA)

ViziRecruiter,LLC.; California (MO); On-site; USD 57,000 - 95,000; Full time

Job summary

AF Group, a premier provider of innovative insurance solutions, is seeking an intermediate-level claim handler for workers’ compensation claims. This remote US-based role handles moderately challenging cases, negotiates settlements within authority, and supports reserving decisions while ensuring compliance with state laws.

The position requires California claims experience, strong investigation, medical knowledge, and excellent communication.

Qualifications

• Bachelor’s degree in a related field or equivalent combination of education and experience.
• Certification or progress toward certification is highly preferred and encouraged.
• Three years of workers’ compensation claims experience required or one year at AF Group Claims Representative I level.

Responsibilities

• Verify workers’ compensation coverage and entitlement.
• Investigate and determine compensability of claims.
• Assess causal relationship and reserve accordingly.
• Facilitate return to work and manage medical bills.
• Negotiate settlements within authority and close files promptly.
• Collaborate with managers on complex matters and manage vendor relationships.

Skills

Computers

Medical terminology

Workers’ comp laws

Communication

Customer service

Negotiation

Prioritization

Attention to detail

Independence

Decision making

Problem solving

Education

Bachelor’s degree in related field

Certification preferred

Job description

AF Group, a premier provider of innovative insurance solutions, is seeking an intermediate-level claim handler for workers’ compensation claims. This remote US-based role handles moderately challenging cases, negotiates settlements within authority, and supports reserving decisions while ensuring compliance with state laws.

The position requires California claims experience, strong investigation, medical knowledge, and excellent communication.