Sr. Workers' Compensation Claims Specialist, Supervisor (REMOTE)

Holmes Murphy Insurance; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

Holmes Murphy Insurance is seeking a Sr. Workers' Compensation Claims Specialist, Supervisor to join the Creative Risk Solutions team. The role requires jurisdictional experience across multiple states and focuses on high-quality claims handling oversight for litigated and complex claims.

You will support staff with goals, career pathing, and engagement. Essential responsibilities include adjudicating claims during staffing shortages, monitoring files, researching inquiries, and communicating

Qualifications

• Jurisdictional experience in multiple states.
• Experience handling litigated and complex workers' compensation claims.
• Ability to provide oversight and guidance to staff.

Responsibilities

• Adjudicate claims during staffing shortages and negotiate settlements per Best Practices.
• Monitor and document claim files focusing on coverage, investigation, reserves, action plans, legal and medical management.
• Research and respond to questions from insureds, claimants, agency partners, and fronting carriers.
• Discuss complex claims and coverage issues with clients; address inquiries.
• Maintain communication with customers and fronting carriers per CRS guidelines.
• Assist staff in managing litigation claims and ensure timely responses.
• Lead and coordinate team meetings and training; support quality service.
• Set and monitor annual goals; participate in claim reviews and risk control workshops.
• Mediate between insured and insurance company and support risk control efforts.

Job description

Job Description:

We are looking to add a Sr. Workers' Compensation Claims Specialist, Supervisor to join our Creative Risk Solutions team. The ideal candidate will have jurisdictional experience in multiple states . This team member will provide high quality claims handling oversight and expertise for all CRS customers on litigated and complex claim situations. This includes assisting staff supervised with investigating, communicating, evaluating, and resolving claims utilizing the CRS Best Practice of Claim Handling. Assisting claim staff with goals, career pathing, and ensuring engagement.

Essential Responsibilities:

Claims Management:

• Adjudicate claims during staffing shortages, investigate, and negotiate settlements per "Best Practices for Claims."
• Monitor and document claim files, focusing on Coverage, Investigation, Reserves, Plan of Action, Legal, and Medical Management. Recommend adjustments as needed.
• Research and respond to questions and complaints from insureds, claimants, agency partners, and fronting carriers.
• Discuss complex claims and coverage issues with clients, addressing any inquiries.
• Maintain communication with customers and fronting carriers per "CRS Communication Expectations" and "Reportable" file guidelines.
• Assist staff in managing litigation claims, ensuring timely responses and protecting the interests of insured and carriers.

Management Responsibilities:

Team Leadership:

• Ensure appropriate staffing, including hiring and terminations.
• Coach team members on workflow, processes, customer service, and client consulting.
• Conduct performance reviews, set goals, and hold employees accountable.
• Foster career development and manage timesheets and compensation decisions.

Team Coordination:

• Facilitate regular team meetings and attend enterprise and leadership training.
• Coordinate training and maintain standardized processes for quality service.
• Provide backup assistance as needed.

Additional Responsibilities:

• Conduct monthly performance meetings and quarterly team meetings.
• Set and monitor annual goals for staff.
• Participate in round tables, claim reviews, and Risk Control Workshops.
• Mediate between insured and insurance company,