Senior Complex Workers’ Comp Claims Leader

memployersmins; United States; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health plans

401k with employer match

Paid parental leave

Flexible Spending Account

Job summary

MEM Insurance seeks a Senior Claims Representative to manage high-exposure workers’ compensation claims, lead investigations, and collaborate across departments to drive strategic outcomes. You will mentor junior adjusters and champion process improvements while ensuring regulatory compliance.

The right candidate will bring 7–10 years of WC claims handling experience, advanced investigative skills, and a commitment to service excellence within a collaborative, values-driven culture.

Qualifications

• 7–10 years of workers’ compensation claims handling with high exposure.
• Bachelor’s degree or equivalent experience; AIC/CPCU designation preferred.
• Texas All-Lines license preferred.

Responsibilities

• Manage highly complex workers’ compensation claims with significant financial exposure.
• Lead investigations into coverage and fraud, coordinating with legal and SIU.
• Oversee medical case management for catastrophic injuries and lifetime care needs.
• Review and authorize large or complex medical bills to control costs.

Skills

High-exposure WC

Investigation leadership

Mentorship

Communication

Driver's license

Education

Bachelor’s degree in business or related field

AIC/CPCU designation preferred

Tools

Case management software

Job description

MEM Insurance seeks a Senior Claims Representative to manage high-exposure workers’ compensation claims, lead investigations, and collaborate across departments to drive strategic outcomes. You will mentor junior adjusters and champion process improvements while ensuring regulatory compliance.

The right candidate will bring 7–10 years of WC claims handling experience, advanced investigative skills, and a commitment to service excellence within a collaborative, values-driven culture.