Sr Claim Examiner- WC

Location: Fairfax, Virginia
Job Type: Full-time, 2-month On-Going Contract, W2
Schedule: Monday – Friday, Remote, EST preferred
Pay: $35.59 per hour
Visa sponsorship is not available now or in the future.

Responsibilities

• Interpret policy coverages and determine claim applicability.
• Manage complex workers' compensation claims throughout the claim lifecycle.
• Conduct and oversee claim investigations.
• Direct litigation and discovery strategy in partnership with legal counsel.
• Establish appropriate reserves and authorize claim payments within authority limits.
• Negotiate and settle claims promptly and equitably.
• Ensure timely issuance of payments and claim disbursements.
• Identify and pursue subrogation and third-party recovery opportunities.
• Analyze claims activity and prepare reports for clients, carriers, and management.
• Participate in claim reviews and provide recommendations on claim strategy.

Requirements

• 4+ years of workers' compensation claims experience.
• Experience handling complex and litigated workers' compensation claims.
• Strong reserve analysis and settlement authority experience.
• Experience with claim investigations and recovery efforts.
• Active Workers' Compensation Adjuster License as required by jurisdiction.
• Ability to work effectively in a remote environment.

Preferred Qualifications

• Experience with subrogation and third-party recovery.
• Prior experience with carriers, TPAs, or self-insured organizations.
• Multi-state workers' compensation claim handling experience.
• Professional insurance industry designations.

Skills

• Strong workers' compensation claims management expertise.
• Advanced investigative and claim resolution skills.
• Excellent written and verbal communication skills.
• Strong negotiation and presentation abilities.
• Ability to work independently and make sound business decisions.
• Advanced analytical and problem-solving capabilities.
• Ability to prioritize and manage multiple claims simultaneously.
• Experience collaborating with legal counsel on litigated claims.

Education

Bachelor's degree or equivalent experience required.