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:
Evaluate and manage claims from initial report to final settlement.
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:
4+ years of experience as a Workers' Compensation Claims Examiner with a deep understanding of both Pennsylvania and New Jersey Workers' Compensation Law.
Insurance Carrier or TPA experience is required
Effective organizational skills and ability to work independently
Bachelors degree in Business, Insurance, or a related field preferred.
Salary/Benefits:
$85,000 to $105,000+ base salary plus Annual Bonus
Employer matching 401(k) plan
Extremely competitive Medical, Dental, Vision and Life plans
Employer Contribution to HSA
Generous PTO
Additional Long-Term Incentive Plans
Flexible work schedule and ability to work from home
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