Senior WC Claims Leader | High-Exposure & Strategy

MEM; United States; On-site; USD 80,000 - 115,000; Full time

Benefits offered by this job

Health plans

Life and disability benefits

401k retirement plan

Paid time off

Parental leave

Education assistance

Job summary

MEM Insurance is seeking a Senior Claims Representative to join our Claims team. You will manage high-exposure workers' compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes.

You will be a key decision-maker, mentor to junior adjusters, and champion of process improvement—ensuring exceptional service and regulatory compliance, while supporting policyholders and injured workers.

Qualifications

• 7–10 years of claims handling experience, with high exposure to Workers' Compensation.
• Bachelor's degree in business or related field preferred, or equivalent industry experience.
• AIC, AIM, or CPCU designation preferred or ability to obtain.
• Valid driver's license required.

Responsibilities

• Manage highly complex claims involving significant financial exposure and extended life cycles.
• Conduct advanced investigations into coverage and compensability.
• Oversee medical case management for catastrophic injuries.
• Review and authorize large or complex medical bills and negotiate adjustments.

Skills

Claims handling

Investigations

Mentoring

Negotiation

Leadership

Regulatory compliance

Education

Bachelor's degree in business or related field

Job description

MEM Insurance is seeking a Senior Claims Representative to join our Claims team. You will manage high-exposure workers' compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes.

You will be a key decision-maker, mentor to junior adjusters, and champion of process improvement—ensuring exceptional service and regulatory compliance, while supporting policyholders and injured workers.