Senior Workers’ Comp Claims Specialist - Hybrid/Remote

Summit; Sumter (SC); Hybrid; USD 79,000 - 107,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) with company match

Employee stock purchase plan

Commuter benefits

Paid time off

Job summary

SCI Summit Consulting, LLC is seeking an experienced Senior Claims professional to manage a large inventory of complex workers’ compensation claims and oversee investigations to determine coverage, liability, and damages.

The role emphasizes analytical thinking, negotiation, and leadership, with responsibilities including authorizing payments, maintaining case files, and guiding less experienced staff. Hybrid work supports in-office presence several days weekly.

Qualifications

• Excellent analytical, negotiation, and problem-solving skills.
• Strong interpersonal and communication skills with the ability to build relationships and lead negotiations.
• Proven ability to handle confidential information with discretion and manage senior-level stakeholders.

Responsibilities

• Manages a large inventory of complex claims to evaluate compensability/liability.
• Plans and conducts complex claims investigations to confirm coverage and ascertain liability, compensability and damages.
• Analyzes and negotiates settlements/reserves within assigned authority; may attend arbitrations, mediations, depositions, or trials.
• Conveys complex information regarding coverage and settlements to insureds, claimants, and external partners.
• Authorizes payments in accordance with authority limits and ensures timely disbursement.
• Maintains accurate and detailed claim files, including correspondence, reports, and settlement agreements.
• May supervise staff and participate in talent decisions for direct reports.
• Performs other duties as assigned.
• Hybrid schedule out of Gainesville, GA office or remotely from states in the Southeast region (GA, IL, TN, IN, SC, KY, NC); on-site four days a week with one remote day.

Skills

Analytical skills

Negotiation skills

Problem-solving

Interpersonal skills

Communication skills

Leadership

Education

Bachelor's degree in Business Administration, Risk Management and Insurance, Finance, or related field

Job description

SCI Summit Consulting, LLC is seeking an experienced Senior Claims professional to manage a large inventory of complex workers’ compensation claims and oversee investigations to determine coverage, liability, and damages.

The role emphasizes analytical thinking, negotiation, and leadership, with responsibilities including authorizing payments, maintaining case files, and guiding less experienced staff. Hybrid work supports in-office presence several days weekly.