Remote Workers' Comp Claims Specialist II

AF Group; Jackson (MS); Remote; USD 57,000 - 95,000; Full time

Job summary

AF Group is seeking an intermediate-level workers' compensation claim handler to analyze and adjudicate moderate-to-difficult claims. This remote US position requires knowledge of California jurisdiction, with flexibility for work from home across the United States.

You will verify coverage, assess compensability, and determine causality while negotiating settlements and managing reserves within your authority.

Qualifications

• Bachelor's degree in a related field preferred or combination of education and experience.
• Three years of workers' compensation claims experience required.
• Experience handling claims across multiple jurisdictions preferred; bilingual skills a plus.

Responsibilities

• Verifies workers' compensation coverage for employers and injured employees.
• Determines a claim's compensability through thorough investigation.
• Assesses causal relationship between injury and incident for benefit payments.
• Facilitates return to work for the injured employee.
• Establishes reserves within authority based on anticipated financial exposure.
• Manages medical bills for indemnity and non-indemnity claims.
• Negotiates settlements within authority to resolve cases promptly.
• Mentors team members and supports complex files with management.

Skills

Oral and written communication

Negotiation

Analytical skills

Attention to detail

Independent work

Education

Bachelor's degree in a related field

Job description

AF Group is seeking an intermediate-level workers' compensation claim handler to analyze and adjudicate moderate-to-difficult claims. This remote US position requires knowledge of California jurisdiction, with flexibility for work from home across the United States.

You will verify coverage, assess compensability, and determine causality while negotiating settlements and managing reserves within your authority.