Senior Claims Specialist - Workers Compensation

Key Responsibilities

• Investigate claims by interviewing insureds, witnesses, and claimants, collecting documentation, and securing evidence to determine coverage, liability, and damages.
• Assess policy coverage, establish reserves, and adjust reserves as needed during claim processing.
• Negotiate settlements within authority limits and coordinate litigation activities, including attending trials.
• Refer claims to specialized units like subrogation or investigations when appropriate.
• Mentor and train team members, assist with caseload management, and participate in quality reviews, mediations, and investigations.

Qualifications & Skills

• Excellent interpersonal, negotiation, and investigative skills.
• Leadership, time management, and resource organization abilities.
• Advanced knowledge of claims handling practices, legal liability, insurance policies, and tort laws, typically gained through a bachelor’s degree and 3-5 years of relevant experience.
• Required licenses maintained throughout employment.