Senior WC Claims Specialist (Remote)

Old Republic Commercial Risk; Irvine (CA); On-site; USD 70,000 - 85,000; Full time

Job summary

Old Republic Commercial Risk in Irvine, CA, seeks an experienced Workers' Compensation Claims professional to independently investigate, evaluate, and resolve high‑complexity claims in line with policy provisions and applicable laws.

You will determine coverage, reserves, and subrogation potential, negotiate settlements, and coordinate with PMA nurses on return-to-work plans, while maintaining top‑tier client service and compliance.

Qualifications

• Bachelor's degree and/or four or more years of equivalent work experience in an insurance related industry.

Responsibilities

• Investigate assigned claims with minimal supervision, including complex cases.
• Determine coverage, compensability, subrogation potential, and second injury fund (when applicable).
• Alerts Supervisor and Special Investigations Unit to suspect claims.
• Ensure timely denial or payment of benefits per jurisdictional requirements.
• Establish reserves with documented rationale and adjust over the life of the claim.
• Negotiate settlements within granted authority.
• Develop action plans for case resolution including medical and disability management.
• Collaborate with PMA nurses on return to work strategies.
• Manage service vendors to balance expenses and outcomes.
• Communicate with internal and external parties on claims issues.

Skills

Communication

Analytical thinking

Organizational skills

MS Office

Education

Bachelor's degree

AIC designation

Tools

MS Office

Job description

Old Republic Commercial Risk in Irvine, CA, seeks an experienced Workers' Compensation Claims professional to independently investigate, evaluate, and resolve high‑complexity claims in line with policy provisions and applicable laws.

You will determine coverage, reserves, and subrogation potential, negotiate settlements, and coordinate with PMA nurses on return-to-work plans, while maintaining top‑tier client service and compliance.