Senior Workers Compensation Claims Specialist

Responsibilities

• Collaborate and communicate with agents, policyholders, and internal stakeholders on claims of medium complexity/severity.
• Investigate losses, identify coverage, determine compensability, and analyze documents and legal pleadings.
• Develop and execute action plans to proactively resolve claims, evaluate damages, negotiate settlements, and close claims in a timely manner.
• Establish and maintain accurate reserves for each claim to reflect financial exposure.
• Engage and manage external resources as needed to ensure proper claim resolution while controlling costs.
• Collaborate with legal counsel to manage litigated claims effectively.
• Review and interpret commercial insurance policies and communicate coverage issues clearly, both verbally and in writing.

Qualifications/Requirements

• Bachelor’s degree or equivalent combination of education and experience.
• Minimum of 3 years of experience handling workers’ compensation indemnity claims of medium complexity/severity.
• Jurisdictional expertise and certification in Arizona claims is required.
• Licensing to cover Arizona, Utah, Texas, and Colorado is mandatory.
• Familiarity with Guidewire (Claims Center) is preferred.
• AIC or SLA certification is a plus.
• Proficient in Microsoft Office Suite and other relevant computer skills.
• Strong analytical skills with exceptional attention to detail.
• Excellent verbal and written communication skills for interaction with internal and external stakeholders.
• Demonstrated ability to build positive relationships and partnerships across departments and with external customers.