WC Claims Oversight Specialist

RLI Insurance Company; Chicago (IL); Hybrid; USD 72,000 - 103,000; Full time

Benefits offered by this job

Annual bonus plans

Employee stock ownership plan (ESOP)

401(k) — automatic 3% company contrib.

Job summary

RLI Insurance Company is seeking a WC Claim Oversight Specialist to monitor external TPA performance on workers’ compensation claims. The role focuses on oversight, not direct handling, ensuring reserve practices and resolution paths align with company standards.

Ideal candidates possess a bachelor’s degree in business or insurance, 6+ years of WC claims experience (supervisory preferred), and strong analytical, communication, and vendor-management skills for a flexible, hybrid work arrangement.

Qualifications

• Bachelor’s degree in business administration, insurance, or related field.
• 6+ years of WC claims handling experience, including complex and litigated files; supervisory experience preferred.
• Experience with vendor-managed claims or quality assurance oversight is a plus.
• Equivalent education and experience accepted.

Responsibilities

• Review higher exposure WC claims managed by the TPA for compliance and alignment with standards.
• Identify concerns about reserve adequacy, litigation strategy, medical management, and settlements.
• Review new claims for assignment and coverage confirmation.
• Collaborate with TPA claim handlers to ensure timely administration and resolution.
• Provide timely feedback to internal stakeholders on claim handling performance.
• Support file audits or performance reviews of the TPA.

Skills

Analytical thinking

Communication skills

Attention to detail

Independent work

Vendor management

Time management

Education

Bachelor’s degree in business administration, insurance, or related field

Equivalent education and experience

Tools

Claims systems experience

Job description

RLI Insurance Company is seeking a WC Claim Oversight Specialist to monitor external TPA performance on workers’ compensation claims. The role focuses on oversight, not direct handling, ensuring reserve practices and resolution paths align with company standards.

Ideal candidates possess a bachelor’s degree in business or insurance, 6+ years of WC claims experience (supervisory preferred), and strong analytical, communication, and vendor-management skills for a flexible, hybrid work arrangement.