WC Claims Resolution Specialist - Special Risk Policyholders

Amerisure; Irving (TX); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive base pay

Performance-based incentive pay

401(k) with profit sharing

Generous paid time off

Job summary

Amerisure in Irving, TX seeks a WC Claims Resolution Specialist – Special Risk Policyholders to manage workers’ compensation claims for insureds with loss‑sensitive programs. This role emphasizes thorough investigations, coverage determinations, and proactive resolution while delivering exceptional service.

Requires a bachelor’s degree, 5 years’ WC claims experience, ability to obtain state licensing, and up to 15% overnight travel.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 5 years of experience handling workers’ compensation claims.
• Ability to obtain appropriate state licensing as required.
• Travel up to 15% overnight.

Responsibilities

• Investigate losses, determine coverage, assess compensability, and review documents.
• Collaborate with legal counsel to manage litigated claims and analyze proceedings.
• Develop and execute proactive claim resolution strategies, including negotiations and settlements.
• Establish and maintain accurate claim reserves reflecting financial exposure.
• Mentor and train other claims handlers.

Skills

Analytical skills

Negotiation

Communication

Relationship building

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Amerisure creates exceptional value for its partners, policyholders, and employees.

As a property and casualty insurance company, Amerisure’s promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee.

With an A.M. Best “A” (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare.

Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus.

Amerisure is currently recruiting for a WC Claims Resolution Specialist – Special Risk Policyholders.

This role will be hybrid in an office 2 days a week (Tuesday & Wednesday).

This role requires Texas expertise, and ideally Arizona, Arkansas and Oklahoma.

The ideal candidate will possess the following skill set.

Summary Statement Manage workers’ compensation claims for insureds with loss-sensitive insurance programs, such as large deductibles and retrospectively rated policies. Conducts thorough investigations, evaluates claims, and ensures effective resolution while delivering exceptional customer service to insureds with loss sensitive insurance policies. Builds robust relationships by demonstrating strong analytical, negotiation, and communication skills, with a focus on delivering quality claim outcomes and excellent service.

Essential Tasks/Major Duties

• Investigate losses, determine coverage, assess compensability, and review and analyze documents and legal pleadings.
• 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.
• Collaborate proactively with agents, policyholders, and internal stakeholders to analyze claims trends, implement risk mitigation strategies, and provide claims education.
• 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.

Knowledge, Skills & Abilities

• 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.
• Proficient computer skills required including Microsoft Office Suite .
• Demonstrated ability to build positive relationships and partnerships within department, across the organization and with external customers.
• Strong analytical skills and attention to detail.
• Excellent verbal and written communication skills with the ability to interact with internal and external customers.
• Ability to travel overnight up to 15%.

Benefits and Rewards

• competitive base pay
• performance-based incentive pay
• comprehensive health and welfare benefits
• a 401(k) savings plan with profit sharing
• generous paid time off programs

We also offer flexible work arrangements to promote work-life balance.

Company Culture and Recognition

Recognized as one of the Best and Brightest Companies to Work For in the Nation and one of Business Insurance magazine’s Best Places to Work in Insurance, we provide a workplace that fosters excellence and professional growth.

If you are looking for a collaborative and rewarding career, Amerisure is looking for you.

Amerisure Mutual Insurance Company is an Equal Employment Opportunity employer.

Amerisure provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (to include sexual orientation and gender identity), national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable federal, state, or local laws.

Amerisure complies with all applicable laws governing nondiscrimination in employment in all locations where the company operates.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Amerisure prohibits harassment or discrimination of any kind and is committed to maintaining a workplace free from unlawful harassment or discrimination.

Amerisure prohibits retaliation against anyone who reports discrimination, participates in an investigation, or opposes unlawful practices.

Any improper interference with an employee’s ability to perform their job duties may result in disciplinary action, up to and including termination.

At Amerisure, we understand that providing insurance coverage, servicing claims and offering loss control services is not enough. What sets us apart in the industry is our people.

Our employees have remained our greatest strength and give life to the service culture we value so much.

We work in a collaborative, cross-functional environment that values the ideas of both our internal and external partners.

Customer service is the cornerstone of our business strategy and a promise we deliver on each day.

If you strive for excellence and are committed to personal and professional growth, Amerisure is looking for you.

https://amerisure.com/careers/