Workers Compensation Claims Specialist

Role: Workers Compensation Claims Specialist Responsibilities Review, analyze, and process moderately to complex claims using advanced technology. Make decisions on liability, evaluate losses, negotiate settlements, and manage claims involving bodily injury or property loss. Conduct investigations by interviewing involved parties, collecting documentation, and securing evidence. Assess policy coverage, determine reserve requirements, and adjust reserves as needed. Coordinate litigation activities, attend trials, and ensure timely, cost-effective resolutions. Assist in assigning claims, providing technical guidance, mentoring team members, and participating in quality reviews. Engage third-party experts such as adjusters and medical examiners; refer claims to specialized units when appropriate. Qualifications & Skills Minimum of 2 years of experience in Workers’ Compensation claims handling, including investigation through resolution. Bachelor’s degree or equivalent work experience; claims adjustment, insurance, or formal training preferred. Knowledge of claims investigation, medical terminology, and legal aspects of claims. Required to obtain and maintain relevant licenses; continuing education for certifications is a plus. #J-18808-Ljbffr