Senior Workers' Comp Claims Strategist

Old Republic Commercial Risk; Charleston (WV); On-site; USD 65,000 - 90,000; Full time

Job summary

Old Republic Commercial Risk seeks a claims professional to investigate, evaluate, and resolve high-complexity workers' compensation claims. You will administer and resolve the highest risk management claims in a timely manner in line with statutes, policy provisions, and company guidelines.

You will determine coverage and eligibility, manage reserves, negotiate settlements, and coordinate return-to-work strategies with PMA nurses.

Qualifications

• Bachelor's degree or four+ years of equivalent work experience in an insurance related industry.
• 3-5 years' experience handling lost time workers compensation claims; MD/DC/WV/PA jurisdiction experience.
• Active license required or ability to obtain license within 90 days in mandated states.

Responsibilities

• Investigate assigned claims with minimal supervision, including complex cases.
• Determine coverage, compensability, and subrogation potential.
• Maintain reserves with documented rationale and adjust over the life of the claim.
• Negotiate settlements with client approval and appropriate documentation.
• Collaborate with PMA nurses to develop return-to-work strategies.
• Select and manage service vendors to balance expense and loss outcome.
• Communicate effectively with internal and external parties.

Skills

Verbal communication

Written communication

Customer service

Organizational skills

Attention to detail

Analytical thinking

Education

Bachelor's degree

AIC designation

Tools

MS Office (Word, Excel, PowerPoint)

Job description

Old Republic Commercial Risk seeks a claims professional to investigate, evaluate, and resolve high-complexity workers' compensation claims. You will administer and resolve the highest risk management claims in a timely manner in line with statutes, policy provisions, and company guidelines.

You will determine coverage and eligibility, manage reserves, negotiate settlements, and coordinate return-to-work strategies with PMA nurses.