Senior Complex Workers' Comp Claims Specialist

Old Republic Commercial Risk; New Orleans (LA); Vor Ort; USD 65.000 - 90.000; Vollzeit

Zusammenfassung

Old Republic Commercial Risk is seeking an experienced Workers' Compensation Claims professional to independently investigate, evaluate and resolve complex claims with minimal supervision. You will determine coverage, reserves, and potential subrogation, and negotiate settlements while complying with state laws and company guidelines.

Responsibilities include timely denial or payment of benefits, coordinating medical/disability management, and collaborating with vendors to balance cost and loss

Qualifikationen

• Bachelor's degree or equivalent work experience in insurance.
• AIC designation or similar preferred.

Aufgaben

• Investigates assigned claims with minimal supervision, including complex cases.
• Determines coverage, compensability, subrogation potential, and second injury fund when applicable.
• Alerts Supervisor and SIU to potentially suspect claims.
• Ensures timely denial or payment of benefits per jurisdictional requirements.
• Establishes reserves with rationale and adjusts them over the life of the claim.

Kenntnisse

Investigation

Communication

Analytical thinking

Negotiation

Time management

Customer service

Ausbildung

Bachelor's degree

AIC designation

Tools

MS Office

Claims software

Jobbeschreibung

Old Republic Commercial Risk is seeking an experienced Workers' Compensation Claims professional to independently investigate, evaluate and resolve complex claims with minimal supervision. You will determine coverage, reserves, and potential subrogation, and negotiate settlements while complying with state laws and company guidelines.

Responsibilities include timely denial or payment of benefits, coordinating medical/disability management, and collaborating with vendors to balance cost and loss