Senior Workers Compensation Claim Specialist

MEMIC; Glastonbury (CT); On-site; USD 90,000 - 110,000; Full time

Job summary

MEMIC is seeking a Lost Time Claim Specialist in Connecticut with several years of experience handling workers’ compensation claims in New England. You will manage complex lost time claims, ensure regulatory compliance, and deliver exceptional service to injured workers, policyholders, and agents.

Responsibilities include investigating and resolving medical-only and lost time claims, coordinating care, administering benefits, and maintaining organized claim files in line with MEMIC’s policies

Qualifications

• 3+ years of Lost Time Claim handling experience.
• Strong knowledge of workers’ compensation claims and jurisdictional compliance.
• Excellent verbal and written communication skills.

Responsibilities

• Investigate, evaluate, and resolve medical-only claims and lost time claims.
• Serve as a point of contact for insureds, injured workers, agents, brokers, attorneys, and other stakeholders to gather necessary information and provide timely updates.
• Administer medical and indemnity benefits in compliance with state workers’ compensation statutes and MEMIC’s best practices.
• Maintain organized and high-quality claim files in accordance with company policies and procedures.
• Implement Managed Care strategies, coordinate rehabilitation plans, process medical bills, and monitor case progress.
• Interact with state and federal boards and commissions to ensure proper reserves and compliance with laws and regulations.
• Stay updated on state laws and workers’ compensation trends through MEMIC-provided training and external certifications like WCP or Claims Law (AEI).

Skills

Lost Time claim handling

Claims management

Communication skills

Job description

CT

Are you an experienced insurance professional ready to take on a specialized role? MEMIC is seeking a Lost Time Claim Specialist with several years of experience handling workers’ compensation claims in New England states.

In this role, you will manage complex lost time claims, ensure compliance with state-specific regulations, and deliver exceptional service to injured workers, policyholders, and agents. Your expertise will help maintain MEMIC’s reputation for excellence in claims management.

What You’ll Do

• Claims Management: Investigate, evaluate, and resolve medical-only claims and lost time claims.
• Communication: Serve as a point of contact for insureds, injured workers, agents, brokers, attorneys, and other stakeholders to gather necessary information and provide timely updates.
• Benefit Delivery: Administer medical and indemnity benefits in compliance with state workers’ compensation statutes and MEMIC’s best practices.
• Quality Assurance: Maintain organized and high-quality claim files in accordance with company policies and procedures.
• Managed Care Coordination: Implement Managed Care strategies, coordinate rehabilitation plans, process medical bills, and monitor case progress.
• Legal & Regulatory Compliance: Interact with state and federal boards and commissions to ensure proper reserves and compliance with laws and regulations.
• Ongoing Learning: Stay updated on state laws and workers’ compensation trends through MEMIC-provided training and external certifications like WCP or Claims Law (AEI).

What You Bring

• 3+ years of Lost Time Claim handling experience
• Strong knowledge of workers’ compensation claims and jurisdictional compliance.
• Excellent verbal and written communication skills.
• Must be adaptable and have the ability to manage time and priorities effectively.
• Strong attention to detail and organizational skills.
• Strong team player with excellent customer service skills.

MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law. Additionally, we are committed to providing an inclusive and accessible recruitment experience for all candidates. If you need a reasonable accommodation during the interview process, please contact us at [e-mail] .

To ensure an equitable and authentic interview process, candidates should not use AI or chatbot tools during the live interview or phone screen. We welcome any preparation you choose to do beforehand, but all responses shared during the interview must be your own.

Note: MEMIC does not offer Stem-OPT EAD Extension for this role.

Check out our benefit offerings here! Targeted salary range: $90,000-$110,000

As set forth in MEMIC’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.

A \"disabled veteran\" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A \"recently separated veteran\" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An \"active duty wartime or campaign badge veteran\" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An \"Armed forces service medal veteran\" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.