senior claims specialist, Risk Management

About Our Client:The organization operates within the risk management industry, providing comprehensive workers’ compensation support. It addresses challenges related to effective claims management by helping injured employees receive timely medical treatment and financial benefits while facilitating early and sustainable return-to-work outcomes. The organization emphasizes a partner-focused approach, regulatory compliance, and risk mitigation to support employee recovery and business continuity.About the Opportunity:The Senior Claims Specialist manages a portfolio of workers’ compensation claims while ensuring timely medical care, wage-loss benefits, and effective risk mitigation. This role provides strategic direction to third-party administrators, oversees claim investigations and litigation strategies, and collaborates with injured employees, healthcare providers, leadership, and other stakeholders. The position balances employee advocacy, regulatory compliance, and operational excellence to support positive recovery and business outcomes.Responsibilities:• Manage an assigned portfolio of workers’ compensation claims from initial reporting through resolution.• Provide strategic direction and oversight to third-party administrators handling claims.• Ensure injured employees receive prompt medical treatment and timely financial benefits.• Facilitate early, appropriate, and sustainable return-to-work solutions.• Conduct and oversee claim investigations, evaluations, and resolution strategies.• Review claim exposure and develop appropriate risk mitigation strategies.• Manage litigation and coordinate legal strategies related to workers’ compensation claims.• Maintain compliance with applicable state workers’ compensation laws and jurisdictional requirements.• Utilize risk mitigation tools and resources appropriately to reduce claim exposure.• Lead discussions with injured employees, organizational leadership, healthcare providers, third-party administrators, and other stakeholders.• Support temporary modified-duty assignments that promote employee recovery while addressing business needs.• Advocate for injured employees while balancing empathy, quality, compliance, and operational effectiveness.• Monitor claim activity and identify opportunities to improve claims management processes and outcomes.• Maintain accurate and confidential claim documentation and records.Requirements:• Bachelor’s degree or equivalent combination of education and relevant work experience.• Minimum 5 years of experience in risk management, workers’ compensation, or claims management.• Strong oral and written communication skills with the ability to communicate clearly and effectively with diverse stakeholders.• Advanced proficiency with Microsoft Office Suite.• Strong negotiation, interpersonal, and relationship-management skills.• Excellent time-management and organizational abilities.• Ability to work effectively both independently and within a team environment.• Ability to maintain confidentiality when handling sensitive employee and claim information.• Consistent and punctual attendance. Equal Opportunity Statement: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 not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.