Workers’ Comp Claims Specialist & Settlements

AF Group; Sacramento (CA); Remote; USD 57,000 - 95,000; Full time

Job summary

AF Group in Sacramento, CA is seeking a Claim Representative II to handle moderate to complex workers' compensation claims, exercising discretion in determinations of compensability and reserves within authority.

You will negotiate settlements, manage medical bills, and collaborate with managers on complex files while ensuring compliance with state laws and internal performance standards.

Qualifications

• Bachelor's degree in a related field.
• Continuous learning, as defined by the Company's learning philosophy, is required.
• Certification or progress toward certification is highly preferred and encouraged.

Responsibilities

• Administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.
• Exercises independent judgment to settle cases prior to mediation or litigation.
• Actively participates in agent/client relationship management.
• Assists in mentoring team members.

Skills

Computers & software

Medical terminology

Legal terminology

Communication skills

Customer service

Negotiation

Multitasking

Detail oriented

Independent decision making

Teamwork

Independent problem solving

Education

Bachelor's degree in related field

Certification or progress toward certification preferred

Tools

Company standard software

Job description

AF Group in Sacramento, CA is seeking a Claim Representative II to handle moderate to complex workers' compensation claims, exercising discretion in determinations of compensability and reserves within authority.

You will negotiate settlements, manage medical bills, and collaborate with managers on complex files while ensuring compliance with state laws and internal performance standards.