Claim Specialist I

About MEMIC

MEMIC’s mission is to improve workers’ compensation insurance through compassionate service, trusted partnerships, and a focus on workplace safety. Core values guide everything: Be Conscientious, Be an Expert, Be a Partner, Be Curious, and Be Transparent. Over 30 years, MEMIC has led in helping businesses protect employees and reduce workplace injuries.

Job Overview

This position is in-person to start then can transition to hybrid. The Claim Specialist I role involves investigating and evaluating claims, managing claims from start to finish, partnering with legal and medical professionals, building strong relationships, and maintaining excellence and compliance.

What You'll Do

• Investigate and Evaluate Claims

• Gather facts, analyze coverage and compensability, determine liability, and assess claim exposure.
• Conduct interviews and maintain communication with injured workers, employers, witnesses, attorneys, brokers, agents, and other stakeholders.

• Manage Claims from Start to Finish

• Administer timely and accurate indemnity and medical benefits.
• Establish appropriate reserves and make informed settlement decisions within authority levels.
• Negotiate claim resolutions and pursue cost-effective outcomes.

• Partner with Legal and Medical Professionals

• Collaborate with defense counsel on litigated claims.
• Attend mediations, arbitrations, hearings, and settlement conferences when needed.
• Implement managed care and rehabilitation strategies to support recovery and claim resolution.

• Build Strong Relationships

• Work directly with insureds and injured employees to provide guidance, education, and support.
• Conduct on-site visits, presentations, and claim reviews to strengthen customer partnerships.

• Maintain Excellence and Compliance

• Ensure claim files meet quality standards, regulatory requirements, and company best practices.
• Stay current on workers’ compensation laws, regulations, and industry trends.
• Utilize technology and claims systems to effectively manage workload and documentation.

What Makes You Successful

• Strong analytical, investigative, and problem-solving skills

• Exceptional communication and negotiation abilities

• Sound judgment and decision-making skills

• The ability to manage multiple priorities in a deadline-driven environment

• Strong customer service and relationship management skills

• Attention to detail and commitment to quality file handling

• A collaborative mindset and team-oriented approach

Preferred Knowledge & Experience

• One year of workers’ compensation claim handling experience preferred

• Computer skills, Word, Excel, and Image Right preferred

• Must have valid driver’s license

• Strong attention to detail and strong communication skills both verbal and written

• Adaptable/flexible and self-directed with the ability to manage time and other resources wisely

• Ability to work effectively with other organizational team members

Benefits

MEMIC offers a targeted salary range of $60,000 - $70,000 annually.