Sr Claim Examiner- WC

This is a Fully Remote Job
About Our Client:
This organization operates in the claims management industry, focusing on addressing the complexities and challenges involved in handling claims effectively. It provides global claims management services aimed at resolving claims efficiently while supporting the well-being of the individuals involved. The company emphasizes comprehensive employee support through wellness and career development programs.
About the Opportunity:
The SENIOR CLAIMS EXAMINER - WORKERS COMPENSATION is responsible for independently managing advanced, large-loss, and complex Workers Compensation claims. This role plays a critical part in evaluating claim compensability, determining liability, managing reserves, and negotiating settlements to ensure fair and timely resolution. The position also involves collaboration with defense counsel on litigated matters and contributing to team development through training and mentoring.
Responsibilities:
Interpret and apply policy coverages to complex claims using independent judgment.
Manage investigative activities and direct litigation strategy in collaboration with legal counsel.
Analyze claims data and prepare reports for clients, carriers, and management.
Establish reserves and authorize payments within authority limits.
Settle claims promptly and equitably, issuing payments as appropriate.
Develop subrogation and third-party recovery opportunities and follow reclaim procedures.
Participate in claim reviews and support team knowledge sharing.
Requirements:
Bachelor’s degree or equivalent experience required; industry designations (IIA, AIC, AEI, CPCU) preferred.
4-8 years of experience in claims investigation and settlement.
Ability to work independently on technical subjects.
Strong communication, negotiation, and presentation skills.
Advanced analytical and problem-solving abilities with multitasking capability.
Effective interpersonal skills for interacting with diverse clients.
Workers Compensation Adjuster License as per jurisdictional requirements.
Pay Range and Compensation Package:
The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors.
Benefits & Perks:
Medical, dental, and vision insurance
Prescription drug coverage
Health savings and flexible spending accounts
Paid holidays, vacation, and sick leave
401(k) retirement plan
Tuition assistance
Paid parental leave
Supplemental health benefits
Enhanced mental health support
Virtual physical therapy
Caregiving services
Life assistance program
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.

Work arrangement
Yes