Senior Workers’ Comp Claims Advocate (Remote)

AF Group; Jackson (MS); Hybrid; USD 57,000 - 95,000; Full time

Job summary

AF Group is seeking an experienced intermediate level claim handler to manage workers' compensation claims, including verification of coverage, determination of compensability, and settlement negotiation within authority.

Responsibilities include facilitating return to work, establishing reserves, handling medical bills, and coordinating with attorneys and vendors to control costs. Strong analytical, negotiation, and communication skills are essential.

Qualifications

• Three (3) years of experience in a workers' compensation claims environment.
• Experience handling claims in multiple jurisdictions preferred.
• Bilingual skills preferred.
• One (1) year of AF Group Claims Representative I experience.

Responsibilities

• Verifies workers' compensation coverage of employers and injured employees.
• Determines compensability under workers' compensation by thorough investigation of the claim.
• Determines causal relationship between the injury and incident to ensure payment of benefits.
• Facilitates return to work for the injured employee.
• Establishes timely reserves based on claim profile within authority.
• Documents specifics of claims with potential for subrogation recovery.
• Manages medical bills for indemnity and non-indemnity claims.
• Approves payment based on treatment plan and relationship to injury.
• Concludes and closes files following resolution to meet internal standards.
• Negotiates settlements with attorneys or injured parties within authority.
• Mentors team members and collaborates with manager on complex files.
• Manages outside vendors to contain costs.

Skills

Negotiation

Communication

Analytical skills

Teamwork

Decision making

Problem solving

Education

Bachelor's degree in a related field

Certification or progress toward certification

Job description

AF Group is seeking an experienced intermediate level claim handler to manage workers' compensation claims, including verification of coverage, determination of compensability, and settlement negotiation within authority.

Responsibilities include facilitating return to work, establishing reserves, handling medical bills, and coordinating with attorneys and vendors to control costs. Strong analytical, negotiation, and communication skills are essential.