Senior Workers' Comp Claims Investigator & Settlements

Old Republic Commercial Risk; Fort Worth (TX); Vor Ort; USD 65.000 - 90.000; Vollzeit

Benefits dieser Stelle

Health insurance

401(k) plan

Paid time off

Zusammenfassung

Old Republic Commercial Risk seeks a Claims professional specializing in Workers’ Compensation claims to independently investigate and resolve complex assigned claims. You will determine coverage, manage reserves, and negotiate settlements within authority while coordinating with PMA for return-to-work strategies.

The role requires TX experience, a relevant designation or progress toward one, and strong communication and analytical abilities to ensure compliant, timely outcomes.

Qualifikationen

• Bachelor's degree and/or four or more years of equivalent work experience required in an insurance related industry.
• TX experience is required.
• Experience handling claims in AR, OK, CO, and LA is preferred, or the ability and willingness to learn preferred jurisdictions.
• Associate in Claims (AIC) Designation or similar professional designation desired
• License required or ability to obtain license within 90 days of employment in mandated states
• Familiarity with medical terminology and/or Workers' Compensation
• Working knowledge of Workers Compensation regulations, preferably jurisdiction-specific
• Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
• Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
• Strong verbal, written communication skills and customer service skills gained through previous work experience
• Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint
• Ability to travel for business purposes, approximately less than 10%.

Aufgaben

• Investigates assigned claims with minimal supervision, including complex cases.
• Determines coverage, compensability, potential for subrogation, and second injury fund considerations.
• Alerts Supervisor and Special Investigations Unit to potentially suspect claims.
• Ensures timely denial or payment of benefits per jurisdictional requirements.
• Establishes reserves with rationale; adjusts reserves over the life of the claim.
• Negotiates settlements within granted authority.
• Develops action plans for case resolution including medical and disability management.

Kenntnisse

Investigative skills

Analytical thinking

Communication

Customer service

Team collaboration

Ausbildung

Bachelor's degree or 4+ years experience

Tools

MS Office

Jobbeschreibung

Old Republic Commercial Risk seeks a Claims professional specializing in Workers’ Compensation claims to independently investigate and resolve complex assigned claims. You will determine coverage, manage reserves, and negotiate settlements within authority while coordinating with PMA for return-to-work strategies.

The role requires TX experience, a relevant designation or progress toward one, and strong communication and analytical abilities to ensure compliant, timely outcomes.