Sr Claims Specialist

Position Summary

This role manages Workers’ Compensation claims overseeing the full claim lifecycle from initial coverage and compensability determinations through investigation, reserving, evaluation, and resolution. The position ensures timely and effective claim handling in compliance with company standards and regulatory requirements, while delivering a high level of service to internal and external business partners.

Primary Responsibilities

• Review and evaluate claim reserves to ensure that the respective reserve properly reflects the potential exposure
• Investigate claims, which may include meeting with Insureds and witnesses, and obtaining statements, records, and other evidentiary materials
• Provide proper documentation and reporting of investigation and claims handling activities
• Negotiates, including through mediation, arbitration, or other court-supervised settlement efforts, settles, and resolves claims with claimants, and their lawyers; provides appropriate claims resolution documents
• Maintain a working knowledge of regulatory and jurisdictional requirements
• Provides direction to and management of defense counsel, independent adjusters and other third parties retained to assist in a particular claim

Qualifications

• Minimum of 5 years of experience with the following:
• Claims Investigation – Statements, authorizations, retention of qualified experts and counsel
• Claims Administration – Reports, review and set accurate and timely reserves, compliance knowledge of laws and procedures, including lost time, serious injury, and litigated claims
• Litigation management – work with defense counsel and experts to resolve litigated claims
• Knowledge of coverage, reserving principles, investigation and negotiation techniques
• Experience handling claims in one or more of the following locations: IA, KS, NE, MN, WI, and SD
• Able to obtain and maintain state adjusting licenses, as needed
• Service-oriented, with the ability to provide prompt, efficient, and effective claims and customer service
• Communicate clearly and effectively with our customers, claimants, opposing counsel, defense counsel, and members of the public
• Manage and organize workload of multiple tasks simultaneously
• Excellent judgement, negotiation, and decision-making skills

Additional Information

• Must be able to travel, potentially overnight
• Benefits: Competitive salary paired with a comprehensive benefits package, Generous paid time off, plus 12 paid holidays annually, Comprehensive health coverage, including medical, dental, and vision plans, Additional protection through accident, critical illness, and hospital indemnity insurance, Company-paid life insurance equal to 2× annual salary, Company-paid short-term and long-term disability coverage, 401(k) Savings and Profit-Sharing Plan through Old Republic, Ongoing education, training, and professional development opportunities, Support for industry certifications and insurance designations, including financial assistance, Flexible scheduling with a two-hour window for start and end times within a 7.5-hour workday, Opportunities to give back through corporate philanthropy and community service initiatives, Optional benefits including travel, commuter, and pet insurance, Employee wellness support through a dedicated fitness program