Senior Workers' Comp Claims Strategist

Old Republic Commercial Risk; Greenville (SC); On-site; USD 72,000 - 94,000; Full time

Job summary

Old Republic Commercial Risk is seeking a claims professional to investigate and resolve complex workers' compensation claims with minimal supervision. You will determine coverage, reserves, and subrogation potential while coordinating with PMA nurses on return-to-work strategies.

The role requires 3–5 years of workers' compensation experience, familiarity with NC/SC/MS jurisdictions, and an active license within 90 days. Strong communication and customer service skills are essential.

Qualifications

• Bachelor's degree or four or more years of equivalent work experience in an insurance related industry.
• 3–5 years' experience handling lost time workers' compensation claims; NC, SC and MS jurisdiction experience preferred.
• AIC designation or similar professional designation desired.
• Active license required or ability to obtain license within 90 days of employment in mandated states.
• Familiarity with medical terminology and Workers' Compensation.
• Strong organizational skills with ability to work independently and manage multiple tasks.
• Excellent verbal and written communication and customer service skills.
• Proficiency with MS Office Suite (Word, Excel, PowerPoint).
• Ability to travel for business, approximately less than 10%.

Responsibilities

• Investigate assigned claims with minimal supervision, including complex cases.
• Determine coverage, compensability, subrogation potential, and second injury fund when applicable.
• Alert Supervisor and SIU to potentially suspect claims.
• Ensure timely denial or payment of benefits per jurisdictional requirements.
• Establish and adjust reserves with documented rationale.
• Negotiate settlements with client approval.
• Develop action plans for case resolution including medical and disability management, litigation management, negotiation and disposition.
• Collaborate with PMA nurses to create return-to-work strategies.
• Select and manage service vendors to balance expense and loss outcome.
• Maintain knowledge of jurisdictional requirements and case law for states served.
• Demonstrate best claim practices through timely execution and clear communication.
• Provide high-level customer service and lead claims reviews with clients.

Skills

Organizational skills

Analytical thinking

Verbal & written communication

Customer service

Education

Bachelor's degree or 4+ years in insurance

AIC designation preferred

Tools

MS Office (Word, Excel, PowerPoint)

Job description

Old Republic Commercial Risk is seeking a claims professional to investigate and resolve complex workers' compensation claims with minimal supervision. You will determine coverage, reserves, and subrogation potential while coordinating with PMA nurses on return-to-work strategies.

The role requires 3–5 years of workers' compensation experience, familiarity with NC/SC/MS jurisdictions, and an active license within 90 days. Strong communication and customer service skills are essential.