Claim Specialist III

Responsibilities

• Investigate, evaluate, negotiate, and resolve lost time claims within settlement and reserving authority
• Communicate with insureds, injured workers, attorneys, and underwriters to determine coverage and liability
• Administer timely and accurate indemnity and medical benefits
• Work with defense counsel on litigated cases, including attending mediations, arbitrations, and hearings
• Maintain quality claim files in accordance with best practices and company procedures
• Implement Managed Care strategies and coordinate medical management
• Maintain proper reserves and interact with State and Federal Boards and Commissions
• Mentor and train less experienced Claim Department representatives
• Keep up-to-date on State laws and company procedures

Requirements

• Mandatory Pennsylvania (PA) claims experience
• Delaware (DE) claims experience is a plus
• 1-2 years of workers’ compensation lost time claim handling experience preferred
• Bachelor’s degree preferred
• Proficiency in Microsoft Word and Excel
• Valid driver’s license
• Strong attention to detail and communication skills

Benefits

• Health, Dental, and Vision insurance options
• 401(k) retirement plan with up to 6% match plus annual bonus
• 5 weeks of Paid Time Off (PTO) and 11 paid holidays
• Paid Parental Leave
• Student loan paydown and refinancing assistance
• Educational assistance for job-related courses and certifications
• Flextime schedules