Job Description
Our client, a leading provider in the insurance industry, is currently seeking an experienced Workers' Compensation Claims Examiner with a proven track record in managing moderate to complex claims in Pennsylvania and New Jersey. This role requires a professional with experience in workers' compensation claims, who is adept at handling high-volume caseloads with a focus on quality and efficiency. Our client is open to candidates working Fully Remote but would prefer the candidate to be domiciled in either PA, NJ, or NY.
Key Responsibilities:
ย Evaluate and manage claims from initial report to final settlement.
ย Negotiate settlements and authorize payments within delegated limits.
ย Ensure compliance with all state regulatory requirements and internal policies.
ย Communicate effectively with policyholders, medical professionals, employers, and legal counsel to gather information and resolve claims.
ย Maintain accurate records and prepare reports for management regarding claim status and resolution.
ย Attend hearings, mediations, and other legal proceedings as required.
ย Provide guidance and training to junior claims staff and support their development.
Qualifications:
ย 4+ years of experience as a Workers' Compensation Claims Examiner with a deep understanding of both Pennsylvania and New Jersey Workers' Compensation Law.
ย Insurance Carrier or TPA experience is required
ย Effective organizational skills and ability to work independently
ย Bachelorยs degree in Business, Insurance, or a related field preferred.
ย Salary/Benefits:
ย $85,000 to $105,000+ base salary plus Annual Bonus
ย Employer matching 401(k) plan
ย Extremely competitive Medical, Dental, Vision and Life plans
ย Employer Contribution to HSA
ย Generous PTO
ย Additional Long-Term Incentive Plans
ย Flexible work schedule and ability to work from home
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