Workers Compensation Claims Specialist - Remote

C. Winchell Agency, Inc.; Jersey City (NJ); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a detail-oriented Workers Compensation Claims Specialist to manage claims efficiently and ensure compliance with best practices. This remote role requires strong analytical skills and a solid background in insurance and risk management. You will oversee claims processes, collaborate with various teams, and maintain relationships with claims teams while ensuring timely and effective resolutions. If you have a passion for helping injured employees and a knack for navigating complex regulations, this is the perfect opportunity for you to make a significant impact in the insurance industry.

Qualifications

• 8+ years of experience in workers' compensation claims in NYC and State.
• Strong knowledge of jurisdictional laws and OSHA regulations.

Responsibilities

• Oversee insurance carriers and TPAs in managing Workers' Compensation claims.
• Collaborate with Risk Management and HR teams for effective claims handling.

Skills

Workers' Compensation Claims Management

Data Analysis

Project Management

Interpersonal Skills

Process Thinking

Decision-Making Skills

Education

Bachelor’s Degree in Insurance

Bachelor’s Degree in Risk Management

Bachelor’s Degree in Finance

Bachelor’s Degree in Business Administration

Tools

Microsoft Office

Risk Management Systems

Job description

Workers Compensation Claims Specialist - Remote

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Job Description

This role involves overseeing insurance carriers and Third-Party Administrators (TPAs) in managing Workers' Compensation claims within an assigned geographic region. Responsibilities include managing incidents, dispatching nurse case managers, collaborating with Risk Management leadership, serving as a resource for injured employees, reporting claims, facilitating early Return to Work programs, evaluating and responding to reserve and settlement consultations, maintaining claim diaries, working with carriers and defense counsel to develop mitigation strategies, attending hearings, managing lien recoveries, monitoring claims handling, and ensuring compliance with best practices.

The role also requires partnering with Safety and HR teams, participating in meetings, maintaining relationships with claims teams, analyzing claim data, supporting audits, and staying current on applicable laws and regulations.

Requirements

This is a remote position with some travel required. Candidates should have a Bachelor’s Degree in Insurance, Risk Management, Finance, Business Administration, or a related field, with at least 8 years of workers' compensation claims experience in New York City and State jurisdictions. Experience in construction environments and insurance designations like CRIS or ARM are preferred. Knowledge of jurisdictional laws, OSHA, medical management, and cost containment programs is necessary. Candidates should demonstrate process thinking, decision-making skills, data analysis ability, project management skills, strong interpersonal skills, and proficiency with Microsoft Office and risk management systems.

Additional Information

Position level: Mid-Senior; Employment type: Full-time; Industry: Insurance; Job function: Human Resources.