Senior Workers' Comp Claims Leader

Mem Ins; Columbia, Northern (SC, KY); Hybrid; USD 85,000 - 120,000; Full time

Benefits offered by this job

Health plans

Life and disability benefits

401k retirement plan

Paid time off

Job summary

MEM Insurance seeks a Senior Claims Representative to manage high-exposure workers’ compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes. You’ll mentor junior adjusters and champion process improvements while ensuring regulatory compliance.

With a culture of integrity and collaboration, MEM Insurance emphasizes delivering exceptional service and supporting employees’ growth and success in a dynamic team environment.

Qualifications

• 7-10 years of claims handling experience, with high exposure to Workers’ Compensation.
• Bachelor’s degree preferred or equivalent industry experience.
• Associate in Claims (AIC), AIM, or CPCU designation preferred or ability to obtain.
• Valid driver’s license required.

Responsibilities

• Manage highly complex claims involving significant financial exposure, legal intricacies, and extended life cycles.
• Conduct advanced investigations into coverage and compensability, including nuanced statutory interpretations.
• Oversee medical case management for catastrophic injuries and lifetime care needs.
• Review and authorize large or complex medical bills, negotiating adjustments to control costs.
• Mentor and coach junior and intermediate adjusters.

Education

Bachelor’s degree in business or related field

Job description

MEM Insurance seeks a Senior Claims Representative to manage high-exposure workers’ compensation claims, lead investigations into coverage and fraud, and collaborate across departments to drive strategic outcomes. You’ll mentor junior adjusters and champion process improvements while ensuring regulatory compliance.

With a culture of integrity and collaboration, MEM Insurance emphasizes delivering exceptional service and supporting employees’ growth and success in a dynamic team environment.