Claims Specialist IV

📋 Description

• Own the full claim lifecycle: Investigate, evaluate, negotiate, and resolve lost time workers’ compensation claims within designated settlement and reserving authority.
• Analyze complex exposures: Assess compensability, medical, legal, and indemnity factors while proactively managing risk and claim cost drivers.
• Navigate jurisdictional requirements: Ensure compliance with state-specific WC laws, litigation processes, and regulatory guidelines.
• Strategically manage claims: Develop and execute resolution strategies, including collaboration with defense counsel, medical providers, and vendors.
• Exercise advanced judgment: Handle a high-exposure, complex caseload with autonomy and limited supervision.
• Develop others: Design and deliver training sessions, research materials, and technical guidance for less experienced adjusters.

🎯 Requirements

• 4 years of WC lost time claim handling required
• Strong negotiation and analytical skills with a focus on resolution
• Ability to work independently with high-quality outcomes
• Passion for mentoring, training, and knowledge sharing
• Demonstrated ability to handle confidential, high-impact situations professionally