Senior Workers' Comp Claims Specialist

AF Group; Winston-Salem (NC); Remote; USD 57,000 - 95,000; Full time

Job summary

AF Group is seeking a Claim Representative II to handle intermediate-level workers' compensation claims. You will verify coverage, determine compensability and causality, facilitate return-to-work, and establish reserves within given authority.

The role includes managing medical bills, researching subrogation potential, and negotiating settlements with attorneys or claimants to reach final dispositions. Ideal candidates have a bachelor’s degree or equivalent experience, with three years in a

Qualifications

• Bachelor's degree or equivalent experience required.
• Certification or progress toward certification is highly preferred.
• Experience in workers' compensation claims environment is required.

Responsibilities

• Verifies workers' compensation coverage and assessments.
• Determines compensability and causality for benefits.
• Facilitates return to work and reserves planning within authority.
• Documents claims with potential subrogation, manages medical bills.
• Negotiates settlements with attorneys or claimants within authority.
• Maintains relationships with internal/external customers and vendors.

Skills

Communication

Negotiation

Multitasking

Attention to detail

Independent decision-making

Problem solving

Oral & written communication

Education

Bachelor's degree in related field

Certification preferred

Job description

AF Group is seeking a Claim Representative II to handle intermediate-level workers' compensation claims. You will verify coverage, determine compensability and causality, facilitate return-to-work, and establish reserves within given authority.

The role includes managing medical bills, researching subrogation potential, and negotiating settlements with attorneys or claimants to reach final dispositions. Ideal candidates have a bachelor’s degree or equivalent experience, with three years in a