Sr. Workers' Claims Examiner | Remote

Position: Sr. Workers' Compensation Claims Examiner | Remote

21 hours ago Be among the first 25 applicants

King's Insurance Staffing provided pay range

This range is provided by King's Insurance Staffing. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$95,000.00/yr - $/yr

Additional compensation types

Annual Bonus

Direct message the job poster from King's Insurance Staffing

Our client, an 'A' rated Insurance Carrier, is currently seeking an experienced Senior Workers' Compensation Claims Examiner with a proven track record in managing moderate to complex claims in Pennsylvania. This role requires a professional with experience in workers' compensation claims, who is adept at handling complex litigated and non-litigated Pennsylvania Lost Time with a focus on quality and efficiency. This is a fully remote position with the ideal candidate residing in PA, NJ, DE, or MD.

Key Responsibilities:

• Responsible for handling a caseload of 80 - 85 Lost Time Pennsylvania Workers' Compensation claims from inception to close.
• Negotiate settlements and authorize payments within delegated limits.
• Ensure compliance with all state regulatory requirements and internal policies.
• Communicate effectively with policyholders, medical professionals, employers, and legal counsel to gather information and resolve claims.
• Maintain accurate records and prepare reports for management regarding claim status and resolution.
• Attend hearings, mediations, and other legal proceedings as required.
• Provide guidance and training to junior claims staff and support their development.

Qualifications:

• 7+ years of experience as a Workers' Compensation Claims Examiner with a deep understanding of Pennsylvania Workers' Compensation Law
• Insurance Carrier experience is required
• Experience and strong knowledge in New Jersey Workers' Compensation Law is a plus
• Strong understanding of Pennsylvania EDI processes and transactions.
• Effective organizational skills and ability to work independently
• Bachelor’s degree in Business, Insurance, or a related field preferred.

Salary/Benefits:

• $95,000 to $110,000+ base salary plus Annual Bonus
• Employer matching 401(k) plan
• Extremely competitive Medical, Dental, Vision and Life plans
• Employer Contribution to HSA
• Generous PTO
• Flexible work schedule and ability to work from home

Seniority level

• Seniority level
  
  Mid-Senior level

Employment type

• Employment type
  
  Full-time

Job function

• Job function Other
• Industries Insurance Carriers and Insurance

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