WC Claims Resolution Lead – Special Risk Policyholders

Amerisure Insurance; Indianapolis (IN); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Amerisure Insurance in the United States is seeking a WC Claims Resolution Specialist for Special Risk Policyholders to manage workers’ compensation claims involving loss-sensitive programs. The role is hybrid, in-office 2 days a week (Tuesday and Wednesday), and requires Texas expertise, with preferred experience in Arizona, Arkansas, and Oklahoma.

You will conduct thorough investigations, evaluate claims, negotiate settlements, and maintain reserves while delivering exceptional service.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 5 years of experience handling workers’ compensation claims of medium to high level of severity/complexity.
• Ability to obtain appropriate state licensing as required.
• Willingness to travel overnight up to 15%.

Responsibilities

• Investigate losses, determine coverage, assess compensability, and review and analyze documents.
• Collaborate with legal counsel to manage litigated claims, leveraging experience to analyze documents and legal proceedings effectively.
• Develop and execute proactive claim resolution strategies, including timely damage evaluations, negotiations, and settlements in accordance with guidelines.
• Establish and maintain accurate claim reserves to reflect financial exposure, ensuring clear and proactive communication with the insured regarding rationale and potential impact.
• Identify and engage external resources as needed to facilitate proper claim resolutions while monitoring and controlling costs.
• Partner with insureds, medical providers, and injured workers to facilitate a safe and timely return to work when appropriate.
• Prepare and deliver detailed claim summaries, reserve updates, and other analyses for agents and insureds.
• Understand and assess loss-sensitive insurance programs, such as large deductible or retrospectively rated policies, keeping insureds informed of financial implications.
• Mentor and train other claims handlers.

Skills

Analytical skills

Negotiation

Communication

Microsoft Office

Education

Bachelor’s degree or equivalent

Tools

Microsoft Office Suite

Job description

Amerisure Insurance in the United States is seeking a WC Claims Resolution Specialist for Special Risk Policyholders to manage workers’ compensation claims involving loss-sensitive programs. The role is hybrid, in-office 2 days a week (Tuesday and Wednesday), and requires Texas expertise, with preferred experience in Arizona, Arkansas, and Oklahoma.

You will conduct thorough investigations, evaluate claims, negotiate settlements, and maintain reserves while delivering exceptional service.