Senior Workers' Comp Claims Specialist & Negotiator

Old Republic Commercial Risk; City of Albany (NY); On-site; USD 85,000 - 115,000; Full time

Job summary

Old Republic Commercial Risk is seeking a qualified Claims professional to independently investigate, evaluate, and resolve high-complexity Workers' Compensation claims. The role involves determining coverage, managing reserves, negotiating settlements, and coordinating with medical and litigation teams.

The ideal candidate has a Bachelor's degree and significant workers' comp experience, with AIC designation or equivalent preferred. Travel up to 10% may be required.

Qualifications

• Bachelor's degree and/or four or more years of equivalent work experience in an insurance related industry.
• CA experience is required; AZ experience is a plus.
• License required or ability to obtain within 90 days in mandated states.
• Familiarity with Workers' Compensation terminology and regulations.
• AIC designation or similar is preferred.

Responsibilities

• Investigate assigned claims with minimal supervision and resolve complex cases.
• Determine coverage, compensability, and subrogation potential.
• Set reserves within granted authority and adjust as needed.
• Negotiate settlements within authority and manage case plans.
• Collaborate with PMA nurse for return-to-work strategies.
• Select and manage service vendors to balance expense and outcomes.
• Maintain knowledge of jurisdictional requirements and case law.

Skills

Investigative skills

Claims adjudication

Analytical thinking

Communication

Travel readiness

Education

Bachelor's degree

AIC designation preferred

Tools

MS Office

Word

Excel

PowerPoint

Job description

Old Republic Commercial Risk is seeking a qualified Claims professional to independently investigate, evaluate, and resolve high-complexity Workers' Compensation claims. The role involves determining coverage, managing reserves, negotiating settlements, and coordinating with medical and litigation teams.

The ideal candidate has a Bachelor's degree and significant workers' comp experience, with AIC designation or equivalent preferred. Travel up to 10% may be required.