Remote Workers' Comp Claims Specialist II

AF Group; Minneapolis (MN); Remote; USD 57,000 - 95,000; Full time

Job summary

AF Group is seeking an intermediate level claims handler for remote work in the United States (California jurisdiction required). You will verify coverage, investigate and determine compensability, establish reserves, and negotiate settlements while coordinating with attorneys and internal teams.

The role emphasizes accuracy, regulatory compliance, and efficient case progression. The candidate will handle complex claims, facilitate return to work, manage medical bills, and mentor teammates as

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' experience in a workers' compensation claims environment with skills in reviewing, investigating and closing claims; multi-jurisdiction experience preferred; bilingual skills a plus.
• Or one year 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 the reported injury and the incident to ensure appropriate payment of benefits.
• Facilitates return to work for the injured employee.
• Establishes timely reserves based on the claim profile within authority and anticipated financial exposure.
• Documents specifics of claims with potential for subrogation recovery.
• Manages medical bills for non-indemnity and indemnity claims related to the injury.
• Approves payment based on treatment plan and medical support.
• Concludes and closes files to meet internal standards while complying with state laws.
• Negotiates settlements within authority at earliest possible point to bring cases to final disposition.

Skills

Negotiation

Communication

Multitasking

Analytical skills

Attention to detail

Independent work

Decision making

Problem solving

Teamwork

Education

Bachelor's degree in related field

Tools

Company software

Job description

AF Group is seeking an intermediate level claims handler for remote work in the United States (California jurisdiction required). You will verify coverage, investigate and determine compensability, establish reserves, and negotiate settlements while coordinating with attorneys and internal teams.

The role emphasizes accuracy, regulatory compliance, and efficient case progression. The candidate will handle complex claims, facilitate return to work, manage medical bills, and mentor teammates as