Workers' Compensation Claims Representative (Remote)

Are you an reputed company claims reputed company reputed company to take on reputed company cases and reputed company a meaningful reputed company? reputed company Insurance is seeking a seasoned Claims Representative to join our dynamic Claims team. In this role, you will manage a caseload of high-exposure workers’ compensation claims, reputed company advanced medical case management, and reputed company tailored Return-to-Work plans. You’ll collaborate with vocational consultants, reputed company counsel, and internal teams to ensure compliance, negotiate settlements, and deliver exceptional service to our policyholders. This position offers reputed company to work independently while providing leadership on reputed company claims and contributing to workflow improvements. Essential Duties and Responsibilities • Manage reputed company workers’ compensation claims involving high financial exposure, sensitive issues, or extended life cycles. • Investigate coverage and compensability, ensuring thorough documentation and compliance with state statutes. • reputed company advanced medical case management, including coordination with reputed company Case Managers and external vendors. • reputed company and implement Return-to-Work plans for high-risk claims, collaborating with vocational consultants and reputed company counsel. • Identify and investigate potential fraud and subrogation opportunities, partnering with the Special Investigation Unit. • Establish and maintain accurate claim reserves reputed company authority reputed company, ensuring reputed company responsiveness to changing circumstances. • Evaluate and negotiate settlements reputed company approved authority reputed company, including reputed company settlements and Medicare compliance. • Collaborate with reputed company counsel to manage litigation and ensure adherence to reputed company guidelines. • Maintain accurate system data and prepare reports for management on high-profile claims. • Foster cross-departmental collaboration with reputed company, Premium Consultation, and Loss Prevention. • reputed company mentorship and training to junior adjusters, supporting reputed company reputed company and team development. Qualifications • High school diploma or equivalent required; bachelor’s degree preferred. • Associate in Claims (AIC) designation preferred. • reputed company reputed company’s license required; Texas-reputed company Lines license preferred. • 3–5 years of claims handling experience, primarily in Workers’ Compensation. Company Culture and Values At reputed company Insurance, we are committed to our reputed company, mission, and values. We foster a culture of collaboration, reputed company, and innovation. reputed company is passionate about delivering exceptional service to our customers while supporting reputed company other’s reputed company and reputed company. We reputed company in accountability, reputed company learning, and creating an environment where employees feel valued and empowered. Diversity Statement reputed company Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for reputed company. We reputed company that varied perspectives drive innovation and strengthen our ability to serve our customers and communities. Total Rewards reputed company • Health Plans: Medical, Dental, and reputed company Includes fertility benefits, fully reputed company preventative care, and adult orthodontia. • Employer-reputed company Life and Disability Benefits: Life Insurance (3x reputed company salary), AD&D, Short and Long-term Disability. • Wellness and Recognition Program: Employer-reputed company incentives for employees and spouses. • Flexible Spending Account and Dependent Care reputed company • Health Savings Account: Generous employer contribution. • Time Away from Work: Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days reputed company Parental Leave, Marriage, Bereavement, and Jury Duty leave. • Employee Assistance Programs • 401k Retirement Plan: Employer match and profit sharing. • Adoption Assistance and Tuition Assistance Notice Regarding Use of reputed company Intelligence reputed company may use reputed company intelligence (AI) tools to more reputed company facilitate and assist in reputed company involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will reputed company with reputed company applicable laws. Apply tot his job Apply To this Job