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Workers Compensation Claims Specialist
Job
Robert Half
Remote
Full-Time
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Job Description
We are looking for a fully remote Senior Workers' Compensation Claims Specialist to assist our client with a long-term project. Candidates must hold a valid New Connecticut adjuster's license. This person will be responsible for managing a complex caseload of workers' compensation claims from inception through resolution. This role ensures compliance with applicable laws and regulations, delivers excellent customer service, and works closely with internal stakeholders, injured employees, medical providers, and legal counsel to facilitate timely and cost-effective claim outcomes.
Key ResponsibilitiesManage a portfolio of high-exposure and complex workers' compensation claims, including litigated cases.
Investigate claims by reviewing reports, medical records, and conducting interviews to determine compensability.
Ensure timely and accurate claim adjudication in accordance with state laws and company guidelines.
Develop and execute claim strategies, including reserve setting and ongoing reserve adjustments.
Coordinate with medical providers, rehabilitation specialists, and case managers to support return-to-work initiatives.
Monitor and manage litigation, working closely with defense attorneys and attending hearings, mediations, and depositions as needed.
Communicate regularly with injured employees, employers, brokers, and other stakeholders regarding claim status.
Key ResponsibilitiesManage a portfolio of high-exposure and complex workers' compensation claims, including litigated cases.
Investigate claims by reviewing reports, medical records, and conducting interviews to determine compensability.
Ensure timely and accurate claim adjudication in accordance with state laws and company guidelines.
Develop and execute claim strategies, including reserve setting and ongoing reserve adjustments.
Coordinate with medical providers, rehabilitation specialists, and case managers to support return-to-work initiatives.
Monitor and manage litigation, working closely with defense attorneys and attending hearings, mediations, and depositions as needed.
Communicate regularly with injured employees, employers, brokers, and other stakeholders regarding claim status.