Senior Remote Workers' Comp Claims Specialist

PMA Companies; Plano (TX); Remote; USD 65,000 - 90,000; Full time

Job summary

PMA Companies is seeking a Back Claims Specialist - Worker's Compensation to independently investigate, evaluate, and resolve more complex claims across TX and regional locations. The role emphasizes timely decisions, coverage determinations, and subrogation review while working with a specialist claims team.

The position requires a Bachelor's degree (or equivalent) and 4+ years in insurance claims, with TX experience; travel up to 10% may be needed.

Qualifications

• Bachelor's degree and/or four or more years of equivalent work experience in insurance claims.
• TX experience is required.
• Experience handling claims in AR, OK, CO, LA is preferred or willingness to learn.
• License required or ability to obtain license within 90 days of employment.

Responsibilities

• Investigate and resolve assigned workers' compensation claims with minimal supervision.
• Determine coverage, compensability, subrogation potential, and second injury fund when applicable.
• Establish reserves within granted authority and adjust as needed over the life of the claim.
• Negotiate settlements within authority and coordinate return-to-work strategies with PMA nurse team.

Skills

Analytical thinking

Communication skills

Organizational skills

Travel readiness

Education

Bachelor's degree

AIC designation or equivalent

Tools

MS Office (Word, Excel, PowerPoint)

Job description

PMA Companies is seeking a Back Claims Specialist - Worker's Compensation to independently investigate, evaluate, and resolve more complex claims across TX and regional locations. The role emphasizes timely decisions, coverage determinations, and subrogation review while working with a specialist claims team.

The position requires a Bachelor's degree (or equivalent) and 4+ years in insurance claims, with TX experience; travel up to 10% may be needed.