Senior Workers' Comp Claims Specialist

New Mexico Mutual; Albuquerque (NM); On-site; USD 70,000 - 90,000; Full time

Job summary

New Mexico Mutual in Albuquerque, NM seeks a Claims Specialist to provide expert handling across coverage, compensability, investigation, evaluation, negotiation, and litigation management for serious and complex workers' compensation claims. You will coordinate with policyholders and manage all aspects of claims with accuracy and efficiency.

The role requires a Bachelor’s degree and 5+ years of workers' compensation claims experience, plus a state adjuster license.

Qualifications

• 5+ years of serious workers' compensation claims experience.
• 10+ claims handling experience.
• State required adjuster’s license.
• Demonstrated proficiency in applying case law to claim handling practices.

Responsibilities

• Evaluate compensability, causation, offsets and exposures of complex claims.
• Document all activities in the claim management system and coordinate with external counsel.
• Set reserves and issue benefits following statutory requirements.
• Prepare for mediation, regulatory proceedings, and court appearances.
• Mentor junior adjusters and support Claims Managers.

Skills

Claims handling

Investigation

Negotiation

Regulatory compliance

Education

Bachelor's degree

Tools

Claim management system

Job description

New Mexico Mutual in Albuquerque, NM seeks a Claims Specialist to provide expert handling across coverage, compensability, investigation, evaluation, negotiation, and litigation management for serious and complex workers' compensation claims. You will coordinate with policyholders and manage all aspects of claims with accuracy and efficiency.

The role requires a Bachelor’s degree and 5+ years of workers' compensation claims experience, plus a state adjuster license.