Senior Workers' Compensation Claims Specialist - Multi-State

PMA Companies; Texas; Hybrid; USD 65,000 - 90,000; Full time

Job summary

PMA Companies seeks a Claims Specialist - Worker’s Compensation to independently investigate and resolve complex claims across multiple states, aligning with statutes and policy provisions. The role demands sound judgment, timely decision-making, and customer-focused service for our clients.

Responsibilities include determining coverage, reserves, settlements, and coordinating with PMA nurses for return-to-work plans, while maintaining strong communication with clients, vendors, and internal

Qualifications

• Bachelor's degree or four+ years of equivalent insurance-related experience.
• Familiarity with Workers' Compensation regulations and terminology.
• Ability to travel for business purposes, <10%.

Responsibilities

• Investigate and resolve assigned claims including complex cases.
• Determine coverage, compensability, and subrogation potential.
• Establish reserves with documented rationale and adjust as needed.
• Negotiate settlements within granted authority and manage action plans.
• Coordinate return-to-work strategies with PMA nurses and manage vendors.
• Maintain knowledge of jurisdictional requirements and applicable law.

Skills

Organizational skills

Critical thinking

Verbal communication

Written communication

Customer service

Travel willingness

Education

Bachelor's degree or equivalent experience

Tools

MS Office (Word, Excel, PowerPoint)

Job description

PMA Companies seeks a Claims Specialist - Worker’s Compensation to independently investigate and resolve complex claims across multiple states, aligning with statutes and policy provisions. The role demands sound judgment, timely decision-making, and customer-focused service for our clients.

Responsibilities include determining coverage, reserves, settlements, and coordinating with PMA nurses for return-to-work plans, while maintaining strong communication with clients, vendors, and internal