Senior Remote Workers' Comp Claims Specialist

PMA Companies; Green Bay (WI); Remote; USD 65,000 - 95,000; Full time

Job summary

PMA Companies' Workers' Compensation Claims team is seeking a Claims Specialist to independently investigate, evaluate and resolve complex claims, ensuring timely decisions in accordance with statutes and policy provisions.

You will determine coverage and compensability, manage reserves and settlements, coordinate return-to-work plans with Lodestar nurses and collaborate with vendors, travel up to 10% as needed.

Qualifications

• Bachelor's degree or four years of equivalent work experience in an insurance related industry.
• License required or ability to obtain license within 90 days in mandated states.
• Experience handling workers' compensation claims and knowledge of related regulations.
• Strong organizational and written/verbal communication skills.

Responsibilities

• Investigates all assigned claims with minimal supervision, including complex cases.
• Determines coverage, compensability, subrogation potential in claims.
• Maintains reserves with rationale; adjusts reserves over the life of the claim.
• Negotiates settlements within granted authority.
• Coordinates return-to-work plans with Lodestar nurses; manages service vendors.
• Communicates with internal and external parties to resolve claims.

Skills

Claims handling

Regulatory knowledge

MS Office

Attention to detail

Education

Bachelor's degree or equivalent experience

Tools

MS Office - Word/Excel/PowerPoint

Job description

PMA Companies' Workers' Compensation Claims team is seeking a Claims Specialist to independently investigate, evaluate and resolve complex claims, ensuring timely decisions in accordance with statutes and policy provisions.

You will determine coverage and compensability, manage reserves and settlements, coordinate return-to-work plans with Lodestar nurses and collaborate with vendors, travel up to 10% as needed.