Senior Workers’ Comp Claims Specialist — Complex Cases

MEM Insurance; Columbia Township (MO); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health plans

Life & Disability

401k

Paid time off

Tuition assistance

Job summary

MEM Insurance in Missouri seeks a seasoned Claims Representative to handle high-exposure workers’ compensation claims, oversee advanced medical case management, and develop tailored Return-to-Work plans. You will collaborate with vocational consultants, legal counsel, and internal teams to ensure compliance and negotiate settlements.

Join a team focused on accountability, collaboration, and innovation. The role offers independent work with leadership on complex claims and opportunities to

Qualifications

• High school diploma or equivalent required; bachelor’s degree preferred.
• Associate in Claims (AIC) designation preferred.
• Missouri All Lines license preferred.
• 3–5 years of claims handling experience, primarily in Workers’ Compensation. Missouri experience preferred.

Responsibilities

• Manage complex workers’ compensation claims with high financial exposure and extended life cycles.
• Investigate coverage and compensability with thorough documentation and state-compliant processes.
• Oversee advanced medical case management and coordination with Nurse Case Managers and vendors.
• Develop and implement Return-to-Work plans for high-risk claims with vocational consultants and legal counsel.

Skills

Workers' comp

Claims handling

Negotiation

Case management

Mentoring

Education

High school diploma or equivalent

AIC designation preferred

Job description

MEM Insurance in Missouri seeks a seasoned Claims Representative to handle high-exposure workers’ compensation claims, oversee advanced medical case management, and develop tailored Return-to-Work plans. You will collaborate with vocational consultants, legal counsel, and internal teams to ensure compliance and negotiate settlements.

Join a team focused on accountability, collaboration, and innovation. The role offers independent work with leadership on complex claims and opportunities to