Senior Workers' Comp Claims Specialist – Complex Claims

PMA Companies; Charlotte (NC); On-site; USD 70,000 - 95,000; Full time

Job summary

PMA Companies is seeking a Sr. Claims Specialist to independently investigate, evaluate and resolve high-risk workers' compensation claims across multiple locations.

The role requires familiarity with jurisdictional requirements and the ability to manage case outcomes with minimal supervision. Responsibilities include determining coverage and subrogation potential, establishing reserves, negotiating settlements, and coordinating with PMA nurse professionals on return-to-work strategies.

Qualifications

• Bachelor's degree or four+ years of equivalent insurance experience required.
• Active license or ability to obtain within 90 days in mandated states.
• Proven ability to handle complex workers' compensation claims with accuracy.

Responsibilities

• Investigate and resolve complex workers' compensation claims with minimal supervision.
• Determine coverage, compensability and subrogation potential.
• Establish and adjust reserves with documented rationale.
• Negotiate settlements with client approval and manage case resolutions.
• Collaborate with nursing professionals on return-to-work strategies.
• Communicate effectively with internal and external stakeholders.

Job description

PMA Companies is seeking a Sr. Claims Specialist to independently investigate, evaluate and resolve high-risk workers' compensation claims across multiple locations.

The role requires familiarity with jurisdictional requirements and the ability to manage case outcomes with minimal supervision. Responsibilities include determining coverage and subrogation potential, establishing reserves, negotiating settlements, and coordinating with PMA nurse professionals on return-to-work strategies.