Senior Workers' Compensation Claims Specialist

Old Republic Commercial Risk; Buffalo (NY); On-site; USD 70,000 - 95,000; Full time

Job summary

Old Republic Commercial Risk is seeking an experienced professional to join our Claims team in Buffalo, NY. You will independently investigate, evaluate, and resolve high-complexity Workers’ Compensation claims, coordinating with medical, legal, and vendor partners to manage outcomes.

You will determine coverage, reserves, and settlement strategies within authority, while staying current on jurisdictional requirements and best practices.

Qualifications

• Bachelor's degree or equivalent insurance experience.
• CA experience required; AZ experience a plus.
• AIC designation desired.
• License required or obtainable within 90 days.
• Familiarity with Workers' Compensation regulations and terminology.

Responsibilities

• Investigate assigned claims with minimal supervision, including complex cases.
• Determine coverage, compensability, subrogation potential, and second injury fund applicability.
• Notify Supervisors/SIU of potentially suspect claims.
• Ensure timely denial or payment of benefits per jurisdictional requirements.
• Establish reserves with documented rationale and adjust as needed.
• Negotiate settlements within granted authority.
• Develop and implement case resolution plans including medical/disability management and litigation handling.
• Collaborate with PMA nurses on return-to-work strategies.
• Select and manage service vendors to balance costs and loss outcomes.
• Maintain knowledge of state-specific statutes and case law for serviced jurisdictions.
• Demonstrate proficient claim practices and effective communication with stakeholders.

Skills

Investigation

Analytical thinking

Communication

Customer service

Multitasking

Education

Bachelor's degree

AIC designation

Tools

MS Office

Job description

Old Republic Commercial Risk is seeking an experienced professional to join our Claims team in Buffalo, NY. You will independently investigate, evaluate, and resolve high-complexity Workers’ Compensation claims, coordinating with medical, legal, and vendor partners to manage outcomes.

You will determine coverage, reserves, and settlement strategies within authority, while staying current on jurisdictional requirements and best practices.