Senior Workers' Comp Claims Strategist

externalpmacompanies; Mount Laurel Township (NJ); On-site; USD 70,000 - 90,000; Full time

Job summary

PMA Companies in Mount Laurel, NJ is seeking an experienced workers' compensation claims professional to independently investigate, evaluate and resolve high-complexity claims, handling coverage, compensability and subrogation decisions.

You will work with PMA nurse professionals on return-to-work strategies, counsel clients, and manage vendors while maintaining jurisdictional knowledge and delivering timely resolutions with strong customer service.

Qualifications

• Bachelor's degree or four+ years of equivalent insurance-related experience.
• 3–5 years' experience handling lost time workers' compensation claims; NJ/PA jurisdiction knowledge required.
• AIC designation or similar designation preferred.
• Active license required or ability to obtain within 90 days in mandated states.
• Familiarity with medical terminology and Workers' Compensation.

Responsibilities

• Investigate assigned claims with minimal supervision, including complex cases.
• Determine coverage, compensability, subrogation, and second injury fund (when applicable).
• Alert Supervisor and Special Investigations Unit to potentially suspect claims.
• Ensure timely denial or payment of benefits per jurisdictional requirements.
• Establish reserves with documented rationale and adjust over the life of the claim.
• Negotiate settlements with client approval.
• Collaborate with PMA nurse professionals on return-to-work strategies.
• Select and manage service vendors to balance cost and loss outcomes.
• Maintain knowledge of jurisdictional requirements and applicable case law.
• Communicate effectively with internal and external parties.
• Provide high degree of customer service during reviews and meetings.
• Comply with Code of Business Conduct and Ethics.

Skills

Investigative skills

Communication skills

Analytical thinking

Customer service

Travel readiness

Education

Bachelor's degree

AIC designation (or similar)

Tools

MS Office

Word

Excel

PowerPoint

Job description

PMA Companies in Mount Laurel, NJ is seeking an experienced workers' compensation claims professional to independently investigate, evaluate and resolve high-complexity claims, handling coverage, compensability and subrogation decisions.

You will work with PMA nurse professionals on return-to-work strategies, counsel clients, and manage vendors while maintaining jurisdictional knowledge and delivering timely resolutions with strong customer service.