WC Claims Representative

The Jonus Group; Omaha (NE); Remote; USD 70,000 - 87,000; Full time

Job summary

An established industry player is seeking an experienced Workers' Compensation Claims Representative to manage lost time claims in a fully remote capacity. This role involves evaluating claims, negotiating settlements, and ensuring effective communication with all stakeholders. The ideal candidate will have a strong background in workers' compensation, particularly in North Carolina, South Carolina, and Tennessee. Join a dynamic team that values professional development and offers a competitive salary and benefits package. If you are skilled in negotiation and problem-solving, this opportunity is perfect for you.

Benefits

Competitive benefits package

Paid time off

Professional development opportunities

Qualifications

• Minimum of three years of experience in workers' compensation claims.
• Experience managing claims in NC, SC, and/or TN.

Responsibilities

• Evaluate compensability and negotiate settlements for lost time claims.
• Manage a caseload of claims across multiple jurisdictions.

Skills

Workers' Compensation Claims Management

Negotiation Skills

Problem-Solving Skills

Organizational Skills

Conflict Resolution Skills

Medical Terminology Familiarity

Communication Skills

Education

Bachelor's Degree

Job description

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Job Summary

This position is for an experienced Workers' Compensation (WC) Claims Representative to manage lost time claims. The role involves working remotely to handle claims from multiple jurisdictions, including North Carolina, South Carolina, and Tennessee. The successful candidate will be responsible for evaluating compensability, negotiating settlements, and overseeing the entire claims process while maintaining consistent communication with stakeholders.

Responsibilities

• Determine compensability and coverage issues for lost time workers' compensation claims.
• Effectively manage a caseload of lost time claims across multiple jurisdictions (NC, SC, TN).
• Negotiate and direct settlements with management review.
• Gather medical and factual evidence to assess compensability.
• Direct external investigations and handle litigation files within given authority.
• Maintain regular contact with claimants, attorneys, outside investigators, rehabilitation personnel, and medical providers.
• Collaborate with insureds, account liaisons, and other stakeholders to ensure claims are managed efficiently.

Qualifications/Requirements

• Minimum of three years of experience handling workers' compensation claims.
• Experience managing claims in North Carolina, South Carolina, and/or Tennessee.
• Bachelor's degree required.
• Carrier experience is preferred.
• Proven experience handling lost time or litigated claims.
• Familiarity with medical terminology.
• Strong organizational, problem-solving, negotiation, and conflict resolution skills.
• Excellent verbal and written communication skills.

Compensation Package

• Salary: $70K - $87K per year (based on experience).
• Competitive benefits package, paid time off, professional development opportunities, etc.
• Fully remote work schedule.

Additional Information

Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

Job Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Sales, Business Development, and Finance
• Industries: Banking, Financial Services, and Insurance