2 workers compensation claims specialist jobs found in Portland, ME

About MEMIC At MEMIC, our mission is to make workers’ compensation insurance better—through compassionate service, trusted partnerships, and an unwavering focus on workplace safety. Our core values— Be Conscientious, Be an Expert, Be a Partner, Be Curious, and Be Transparent —drive everything we do. For over 30 years, we’ve been a leader in helping businesses protect their employees and reduce workplace injuries while delivering exceptional claims services. Job Overview: Associate Claim Specialist This position is in-person to start then can transition to hybrid. Are you looking to build a career in insurance claims management ? Join MEMIC as an Associate Claim Specialist and be part of a team dedicated to providing fair, accurate, and compassionate claims resolution. In this role, you will investigate, evaluate, and manage medical-only and low-complexity lost time claims, ensuring injured workers receive appropriate care and benefits while...

The Quality Assurance Specialist’s primary responsibility is to monitor and review claims to ensure compliance with MEMIC’s internal best practices, as well as statutory requirements, and to develop and implement strategies to improve compliance in these areas. In addition, this position may be called upon to assist and support the compliance and training staff in the development of compliance plans and training documentation. Responsibilities: Monitors indemnity claim file activity in real time to ensure jurisdictional benchmarks related to timeliness of initial compensability determinations, accuracy of payments and/or denials, and completion of forms over the life of the claim are met. Reviews state specific legal orders to ensure timely response, payment and form filings, when applicable. Reconciles penalties incurred to confirm validity and provides recommendations to Claim Management on the appropriateness of a payment or an appeal, when applicable.Identifies,...