Claims Specialist

• Provide full cycle support for workers' compensation, general liability, product, and cyber claims
• Engage directly with team members to provide service
• Process and document claims in compliance with legislative provisions, company policies, and insurance industry best practices
• Act in a fiduciary role for the large deductible
• Consult on the calculation and posting of claim case reserves
• Negotiate and resolve claims
• Manage claims from beginning to closure
• Serve as the primary contact for claim mitigation and resolution recommendations and decisions
• Provide end-to-end administrative support for return-to-work assignments for full and restricted returns across U.S. QVC locations and panel providers
• Track and comply with necessary statistics for management
• Evaluate and submit settlement authority proposals and reserve increases and decreases
• Prepare reports detailing claim status, payments, reserves, and claim trends

• 3+ years leading end-to-end review of insurance claims
• 3+ years supporting workers' compensation and general liability claims
• 3+ years using claims service vendor systems or onsite database software to maintain claims history continuity
• 3+ years using customer portals, payroll and HR resource systems, and team member data management
• 3+ years applying jurisdictional requirements and applicable case law for each claim and respective state
• 3+ years partnering with panel providers to evaluate claims
• Experience documenting the claim review cycle preferred
• Must reside in New Jersey, Delaware, or Pennsylvania
• Relocation assistance is not available

Demonstrates expertise in managing the full cycle of insurance claims, including workers' compensation and general liability, while ensuring compliance with legislative provisions and industry best practices. Proficient in utilizing claims service vendor systems and customer portals for effective claims management and reporting.

• Workers' Compensation Claims Management
• General Liability Claims Support
• Claims Service Vendor Systems
• Claims Documentation and Reporting
• Jurisdictional Requirements Application

• Claims Processing
• Claims Negotiation
• Claims Documentation
• Claims Reserve Calculation
• Claims Trend Analysis

• Team Collaboration
• Customer Service

• Insurance Industry Best Practices
• Fiduciary Role
• Claim Mitigation
• Settlement Authority Proposals
• Return-to-Work Assignments

• Claims Service Vendor Systems
• Customer Portals
• Payroll Systems
• HR Resource Systems