WC Claims Specialist II – Negotiation & Resolution

AF - Group; United States; On-site; USD 56,700 - 94,900; Full time

Job summary

AF Group is hiring an intermediate-level workers’ compensation claims handler in the United States. The role involves handling moderate to difficult claims, exercising discretion in compensability determinations, and managing claim reserves within authority.

You will work to settle cases efficiently while maintaining compliance with applicable laws and company standards. The position requires a bachelor’s degree in a related field and several years of claims experience, with certification

Qualifications

• Bachelor's degree in a related field.
• Three years of workers' compensation claims experience; multi-jurisdiction experience preferred; bilingual skills preferred.
• Certification or progress toward certification is highly preferred and encouraged.

Responsibilities

• Verifies workers' compensation coverage of employers and injured employees.
• Determines compensability under workers' compensation by investigation of the claim.
• Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits.
• Facilitates return to work for the injured employee.
• Establishes timely and appropriate reserves based on the profile of the claim within given authority.
• Documents specifics of claims with potential for subrogation recovery.
• Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury.
• Negotiates settlements with attorneys or injured parties within given authority at the earliest possible point to bring cases to final disposition.
• Mentors team members.

Skills

Negotiation

Communication

Attention to detail

Analytical skills

Time management

Education

Bachelor's degree in a related field

Three (3) years of workers' compensation claims experience

Certification preferred / progress toward certification

Job description

AF Group is hiring an intermediate-level workers’ compensation claims handler in the United States. The role involves handling moderate to difficult claims, exercising discretion in compensability determinations, and managing claim reserves within authority.

You will work to settle cases efficiently while maintaining compliance with applicable laws and company standards. The position requires a bachelor’s degree in a related field and several years of claims experience, with certification