Claims Specialist
Core
Manages complex workers' comp claims, investigating liability and compensability, negotiating settlements, and authorizing payments.
Role type
Senior Claims Specialist (Workers' Compensation)
Builds
Claim resolutions and settlements for workers' compensation policyholders
Domain
Insurance / Workers' Compensation
Required skills
complex claims investigation, liability assessment, settlement negotiation, reserve analysis, policy interpretation, regulatory compliance, caseload management, staff coaching
Preferred skills
Associate in Claims (AIC) designation, arbitration/mediation experience
Technologies
Claims management systems, legal databases
Responsibilities
Evaluate compensability and liability for complex claims; conduct investigations to confirm coverage; negotiate settlements and reserves; convey coverage information to insureds and claimants; authorize payments within authority limits; maintain detailed claim files; coach and manage staff performance.
Seniority
Senior, hands-on IC with potential leadership responsibilities