Senior Workers' Compensation Claims Specialist | Remote
Our client, a respected leader within the insurance sector, is seeking a Senior Workers’ Compensation Claims Specialist to join their growing team. The ideal candidate will have a demonstrated ability to manage moderate to complex Pennsylvania and New Jersey Workers’ Compensation Lost Time claims while maintaining a strong commitment to accuracy, timeliness, and exceptional service. This position offers remote flexibility, though candidates should be based in Pennsylvania.
Key Responsibilities
• Oversee the full life cycle of PA and NJ Workers’ Compensation claims from first notice of loss through resolution and settlement.
• Manage a pending of 115 - 125 files; negotiate settlements and approve payments within designated authority levels.
• Ensure strict compliance with state regulations and internal claims procedures.
• Collaborate with policyholders, attorneys, medical providers, and employers to secure needed documentation and facilitate claim resolutions.
• Maintain thorough claim files and prepare timely status and progress reports for management.
• Participate in hearings, mediations, and related legal proceedings when necessary.
• Serve as a resource and mentor for junior examiners, offering technical support and guidance.
Qualifications
• 3 - 7+ years of experience handling workers’ compensation claims with solid knowledge of PA and NJ regulations.
• Insurance carrier or TPA experience required.
• Active Adjuster License preferred.
• Strong organizational, analytical, and communication skills with the ability to manage tasks independently.
• Bachelor’s degree in Business, Insurance, or a related discipline preferred.
Compensation & Benefits
• Competitive base salary of $85,000 – $105,000+ with annual bonus potential.
• 401(k) with employer match.
• Comprehensive medical, dental, vision, and life insurance coverage.
• Employer contribution toward HSA.
• Generous PTO and flexible scheduling.
• Remote work option for qualified candidates.
Employment Type: FULL_TIME
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