Senior Workers’ Claims Specialist

Vensure Employer Solutions is the largest privately held organization in the HR technology and service sector, providing a comprehensive portfolio of solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO). The company and its service providers collectively serve over 95,000 businesses and process over $135B in annual payroll. As a  One Employer Solution  headquartered in Chandler, Arizona, Vensure helps thousands of businesses streamline and grow their operations with custom strategies that benefit both employers and employees.

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Senior Workers' Compensation Claims Specialist will service our multi-state clients' workers' compensation claims with little to no supervision required. This role requires that the claims specialist monitor their assigned employers' workers' compensation claims, from inception through closure, to ensure that all salient aspects of claim adjudication are being effectively and efficiently performed. This position will also be the main point of contact for client education on general work comp matters.

• Lead comprehensive investigations of complex workers' compensation claims, including in-depth coverage analysis, compensability determinations, medical review, witness statements, and employer documentation, and provide detailed findings and strategic recommendations to the third-party administrator (TPA) adjuster.
• Evaluate and respond to TPA requests for reserve and settlement authority, conducting advanced exposure assessments based on medical prognosis, statutory benefits, vocational factors, litigation risk, and historical claim patterns to ensure appropriately set reserves and fiscally sound settlement decisions.
• Perform sophisticated claim evaluations to determine potential financial and operational exposure, identifying high-risk factors, potential red flags, subrogation opportunities, and long-term cost drivers, and advising clients on proactive strategies to mitigate future loss.
• Serve as a high-level consultant to clients on risk mitigation, analyzing claim trends, identifying systemic issues, recommending safety improvements, and developing strategies that reduce workplace injuries and claim frequency. Provide empathetic and expert-level communication to injured workers by offering clear guidance, answering complex questions, supporting their understanding of the claims process, and acting as a knowledgeable, compassionate advocate while balancing employer interests.
• Support clients in developing and optimizing return-to-work (RTW) programs, including identifying alternative/light-duty assignments, evaluating functional capacity, and advising on transitional work opportunities to accelerate recovery and reduce indemnity costs.
• Act as a strategic liaison between clients, TPA adjusters, defense counsel, medical providers, and injured employees, ensuring coordinated case management, clear communication pathways, and reduced litigation exposure through early intervention and proactive engagement.
• Continuously monitor claim progression, ensuring timely action on medical updates, legal developments, benefit delivery, adjuster activity, and compliance with jurisdictional requirements, while identifying delays or inaccuracies that require escalation.
• Manage a portfolio of complex workers' compensation claims from initial filing through closure, directing claim strategies, driving timely resolution, ensuring accurate documentation, and influencing case outcomes through expert guidance and oversight.
• Identify process improvements, leveraging data, claim trends, and client feedback to enhance the effectiveness of the workers' compensation program and improve overall claim outcomes.
• Mentor and support junior claims staff, sharing expertise, offering case guidance, and contributing to the development of best-practice procedures across the claims team.
• Regular attendance at the assigned work location for our corporate office locations is an essential job function. For team members who are located in or near the Chandler, AZ and Duluth, GA offices, this is an in-office position.
• Occasional domestic travel will be required to attend team onsite meetings, client visits, customer events, industry conferences, and training sessions. This may include air travel, ground transportation (including cars, taxis, or rideshare services), and in some cases potential public transportation.
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