The Claims Specialist provides expert handling of complex workers' compensation claims, focusing on coverage, investigation, evaluation, negotiation, and litigation management in accordance with laws and policies.
Responsibilities include assessing claim compensability, documenting activities, managing reserves, ensuring timely benefit payments, and participating in legal proceedings. They analyze claims for trends, recommend settlements, mentor junior staff, and detect potential fraud.
Requires a bachelor’s degree, 5+ years’ experience in serious workers’ compensation claims, and a valid adjuster’s license. The role emphasizes Service Excellence, Trust, Ownership, and teamwork, with a positive attitude and strong communication skills. Work conditions involve light physical demands, adherence to safety, and a drug-free environment.