Senior Workers' Comp Claims Specialist – Complex Cases

Old Republic Commercial Risk; Allentown (Lehigh County); On-site; USD 70,000 - 95,000; Full time

Job summary

Old Republic Commercial Risk seeks an experienced Workers' Compensation Claims professional to independently investigate, evaluate, and resolve complex claims, ensuring outcomes align with statutes, policy provisions, and company guidelines.

You will administer high‑risk claims, manage reserves, negotiate settlements, and collaborate with PMA nurses to support return‑to‑work, while maintaining superior customer service across states with up to 10% travel.

Qualifications

• Bachelor's degree or four+ years in an insurance-related role.
• Experience handling workers' compensation claims preferred, NJ/PA knowledge a plus.
• Active license or ability to obtain within 90 days in required states.

Responsibilities

• Investigate assigned claims with minimal supervision, including complex cases.
• Determine coverage, compensability, and subrogation potential.
• Set and adjust reserves with documented rationale.
• Negotiate settlements with client approval.
• Coordinate return‑to‑work strategies with PMA nurses.
• Interact with internal and external parties on claims issues.
• Collaborate with vendors to balance cost and outcomes.
• Maintain knowledge of state-specific laws governing claims.

Skills

Claims investigation

Analytical thinking

Communication skills

Customer service

Travel readiness

Team collaboration

Education

Bachelor's degree in related field

AIC designation desired

Tools

MS Office

Claims management systems

Job description

Old Republic Commercial Risk seeks an experienced Workers' Compensation Claims professional to independently investigate, evaluate, and resolve complex claims, ensuring outcomes align with statutes, policy provisions, and company guidelines.

You will administer high‑risk claims, manage reserves, negotiate settlements, and collaborate with PMA nurses to support return‑to‑work, while maintaining superior customer service across states with up to 10% travel.