Senior Workers' Compensation Claims Specialist | Remote

Job Description

Job Description

Our client, a respected leader within the insurance sector, is seeking a Senior Workers’ Compensation Claims Specialist to join their growing team. The ideal candidate will have a demonstrated ability to manage moderate to complex Pennsylvania and New Jersey Workers’ Compensation Lost Time claims while maintaining a strong commitment to accuracy, timeliness, and exceptional service. This position offers remote flexibility, though candidates should be based in Pennsylvania.

Key Responsibilities

Oversee the full life cycle of PA and NJ Workers’ Compensation claims from first notice of loss through resolution and settlement.

Manage a pending of 115 - 125 files; negotiate settlements and approve payments within designated authority levels.

Ensure strict compliance with state regulations and internal claims procedures.

Collaborate with policyholders, attorneys, medical providers, and employers to secure needed documentation and facilitate claim resolutions.

Maintain thorough claim files and prepare timely status and progress reports for management.

Participate in hearings, mediations, and related legal proceedings when necessary.

Serve as a resource and mentor for junior examiners, offering technical support and guidance.

Qualifications

3 - 7+ years of experience handling workers’ compensation claims with solid knowledge of PA and NJ regulations.

Insurance carrier or TPA experience required.

Active Adjuster License preferred.

Strong organizational, analytical, and communication skills with the ability to manage tasks independently.

Bachelor’s degree in Business, Insurance, or a related discipline preferred.

Compensation & Benefits

Competitive base salary of $85,000 – $105,000+ with annual bonus potential.

401(k) with employer match.

Comprehensive medical, dental, vision, and life insurance coverage.

Employer contribution toward HSA.

Generous PTO and flexible scheduling.

Remote work option for qualified candidates.