19 workers comp claim representative i jobs found

SUMMARY   This is the entry level professional claim handler. Handles medical only and indemnity benefits.  Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.    ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. Verifies workers’ compensation coverage of employers and injured employees.   Determines compensability under workers’ compensation by thorough investigation of the claim.   Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. Facilitates return to work for the injured employee. Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure. Documents specifics of claims with potential for subrogation recovery, including amount of...

SUMMARY:     This is the entry level professional claim handler. Handles medical only and indemnity benefits.  Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.    RESPONSIBILITIES/TASKS: Verifies workers’ compensation coverage of employers and injured employees.   Determines compensability under workers’ compensation by thorough investigation of the claim.   Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. Facilitates return to work for the injured employee. Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure. Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies. Manages medical bills for...

SUMMARY:     This is the entry level professional claim handler. Handles medical only and indemnity benefits.  Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.    RESPONSIBILITIES/TASKS: Verifies workers’ compensation coverage of employers and injured employees.   Determines compensability under workers’ compensation by thorough investigation of the claim.   Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. Facilitates return to work for the injured employee. Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure. Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies. Manages medical bills for...

NJM’s WC Claims Department is seeking an experienced Claims Specialist, Sr. who lives in Western or Central PA to provide on-site service to our policyholders and agents in that area.   This is a 100% remote position which includes virtual claims handling for customers in any area of PA and possibly MD, DE or CT as needed.   At NJM, our WC Claims Department empowers our employees to focus on delivering guidance and empathy to our customers.  As a department driven by service and customer advocacy, we are committed to providing transparent, empathetic support and collaborative engagement during the life of a claim. The WC Claims Department takes pride in being a key component in the growth and success of our policyholders’ business operations. To meet these expectations, WC Claims Specialists are supported by a dedicated call center who can field calls for them and other specialized units who are responsible for setting reserves, making permanency payments, and following...

SUMMARY:     Claim Representative I:  This is the entry level professional claim handler. Handles medical only and indemnity benefits.  Exercises some discretion in the determination of compensability of claims.  Considers many factors in the determination claim reserves.  Negotiates and settles claims within given authority.    Claim Representative II:  This is the intermediate level of the claim handler career path.  Handles moderate to difficult claims.  Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves.  Negotiates and settles claims within given authority.    Claim Representative III:  This is the advanced level of the claim handler career path.  Investigates claims and exercises significant discretion in the determination of compensability of claims.  May handle large, more complex customers requiring high touch, labor intensive claim service.  Considers many...

SUMMARY:     Claim Representative I:  This is the entry level professional claim handler.  Handles medical only and indemnity benefits.  Exercises some discretion in the determination of compensability of claims.  Considers many factors in the determination claim reserves.  Negotiates and settles claims within given authority.    Claim Representative II:  This is the intermediate level of the claim handler career path.  Handles moderate to difficult claims.  Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves.  Negotiates and settles claims within given authority.    Claim Representative III:  This is the advanced level of the claim handler career path.  Investigates claims and exercises significant discretion in the determination of compensability of claims.  May handle large, more complex customers requiring high touch, labor intensive claim service.  Considers many...

SUMMARY     This is the advanced level of the claim handler career path. Investigates claims and exercises significant discretion in the determination of compensability of claims. May handle large, more complex customers requiring high touch, labor intensive claim service. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Mentors lower-level claim handlers. Coordinates special projects and provides guidance to others. Candidate must have California experience.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. Verifies workers’ compensation coverage of employers and injured employees.   Determines compensability under workers’ compensation by thorough investigation of the claim.   Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. Facilitates return to work for the injured employee....

Porch Group is a leading vertical software and insurance platform and is positioned to be the best partner to help homebuyers move, maintain, and fully protect their homes. We offer differentiated products and services, with homeowners insurance at the center of this relationship. We differentiate and look to win in the massive and growing homeowners insurance opportunity by 1) providing the best services for homebuyers, 2) led by advantaged underwriting in insurance, 3) to protect the whole home. As a leader in the home services software-as-a-service (“SaaS”) space, we’ve built deep relationships with approximately 30 thousand companies that are key to the...

Discover a Career That Empowers You — Join HUB International! At HUB International, we’re more than just an insurance brokerage firm — we’re a thriving community of entrepreneurs driven by purpose and passion. Every day, we help individuals, families, and businesses protect what matters most by providing a broad array of insurance, retirement, and wealth management products and services. But we don’t stop there — we also invest deeply in our people. Here, your career is in your hands. You’ll be empowered to learn, grow, and truly make an impact. Whether you're supporting a local business or helping a national client navigate complex risk, you’ll be backed by the strength of a global firm and the heart of a regional team. As one of the world’s largest insurance brokers — and a proud Stevie Award-winning workplace — HUB offers a unique blend of big-company resources and entrepreneurial spirit. With over 20,000 professionals across 570+ offices in North America, we bring...

Discover a Career That Empowers You — Join HUB International! At HUB International, we’re more than just an insurance brokerage firm — we’re a thriving community of entrepreneurs driven by purpose and passion. Every day, we help individuals, families, and businesses protect what matters most by providing a broad array of insurance, retirement, and wealth management products and services. But we don’t stop there — we also invest deeply in our people. Here, your career is in your hands. You’ll be empowered to learn, grow, and truly make an impact. Whether you're supporting a local business or helping a national client navigate complex risk, you’ll be backed by the strength of a global firm and the heart of a regional team. As one of the world’s largest insurance brokers — and a proud Stevie Award-winning workplace — HUB offers a unique blend of big-company resources and entrepreneurial spirit. With over 20,000 professionals across 570+ offices in North America, we bring...

Discover a Career That Empowers You — Join HUB International! At HUB International, we’re more than just an insurance brokerage firm — we’re a thriving community of entrepreneurs driven by purpose and passion. Every day, we help individuals, families, and businesses protect what matters most by providing a broad array of insurance, retirement, and wealth management products and services. But we don’t stop there — we also invest deeply in our people. Here, your career is in your hands. You’ll be empowered to learn, grow, and truly make an impact. Whether you're supporting a local business or helping a national client navigate complex risk, you’ll be backed by the strength of a global firm and the heart of a regional team. As one of the world’s largest insurance brokers — and a proud Stevie Award-winning workplace — HUB offers a unique blend of big-company resources and entrepreneurial spirit. With over 20,000 professionals across 570+ offices in North America, we bring...

You have a clear vision of where your career can go. And we have the leadership to help you get there.  At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.  This individual contributor position works under general direction, and within broad authority limits, to provide technical oversight of complex, high-exposure commercial Workers’ Compensation claims handled by Third-Party Administrators (TPAs). While not responsible for people management, the role functions as a subject matter leader, influencing claim outcomes through expertise, collaboration, and oversight. The position is responsible for reviewing and guiding claim strategies, reserves, and resolution plans to ensure alignment with company protocols, regulatory requirements, and best practices. Success in this role requires the ability to lead through influence by setting...

Discover a Career That Empowers You — Join HUB International! At HUB International, we’re more than just an insurance brokerage firm — we’re a thriving community of entrepreneurs driven by purpose and passion. Every day, we help individuals, families, and businesses protect what matters most by providing a broad array of insurance, retirement, and wealth management products and services. But we don’t stop there — we also invest deeply in our people. Here, your career is in your hands. You’ll be empowered to learn, grow, and truly make an impact. Whether you're supporting a local business or helping a national client navigate complex risk, you’ll be backed by the strength of a global firm and the heart of a regional team. As one of the world’s largest insurance brokers — and a proud Stevie Award-winning workplace — HUB offers a unique blend of big-company resources and entrepreneurial spirit. With over 20,000 professionals across 570+ offices in North America, we bring...

At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship.  We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together.  Come be a part of this journey with us as we champion lives! Job Summary LTD Claims Associates are responsible to contribute to the overall success of OneAmerica's objectives by providing timely and accurate support to our customers and the claims department. To obtain and analyze information in order to make claim decisions and payments on disability claims. To develop and apply appropriate claim and disability management techniques to ensure prompt and accurate payment and liability management of disability claims. To provide responsive customer service to claimants, policyholders, brokers, and internal departments....

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Senior Claims Examiner - WC .    The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker’s compensation insurance claims through effective research, negotiation and interaction with insures, and claimants, ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor.  Responsibilities Thoroughly investigating workers’ compensation claims by contacting injured workers, medical providers, and employer representatives. Determining if claims are valid under applicable workers’ comp statutes. Communicating with medical providers to develop and authorize appropriate treatment plans. Reviewing and analyzing medical bills to confirm charges and treatment are workers’ comp injury-related and...

Location:  This role requires a hybrid work schedule out of our San Francisco, CA office 2 days a week. SUMMARY: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. ESSENTIAL DUTIES AND RESPONSIBILITIES : · Primary expert resource and first point of contact for clients, which includes research/analysis and handling of a wide variety of client questions regarding risk management, coverage/eligibility, contractual issues, and government reporting compliance. Prepares endorsements per client requests. Prepares and provides resource, trend and legal update information to clients on on-going basis. Routine questions are delegated. · For new and renewal business, analyzes relevant client data (e.g. experience...

Discover a Career That Empowers You — Join HUB International! At HUB International, we’re more than just an insurance brokerage firm — we’re a thriving community of entrepreneurs driven by purpose and passion. Every day, we help individuals, families, and businesses protect what matters most by providing a broad array of insurance, retirement, and wealth management products and services. But we don’t stop there — we also invest deeply in our people. Here, your career is in your hands. You’ll be empowered to learn, grow, and truly make an impact. Whether you're supporting a local business or helping a national client navigate complex risk, you’ll be backed by the strength of a global firm and the heart of a regional team. As one of the world’s largest insurance brokers — and a proud Stevie Award-winning workplace — HUB offers a unique blend of big-company resources and entrepreneurial spirit. With over 20,000 professionals across 570+ offices in North America, we bring...

Discover a Career That Empowers You — Join HUB International! At HUB International, we’re more than just an insurance brokerage firm — we’re a thriving community of entrepreneurs driven by purpose and passion. Every day, we help individuals, families, and businesses protect what matters most by providing a broad array of insurance, retirement, and wealth management products and services. But we don’t stop there — we also invest deeply in our people. Here, your career is in your hands. You’ll be empowered to learn, grow, and truly make an impact. Whether you're supporting a local business or helping a national client navigate complex risk, you’ll be backed by the strength of a global firm and the heart of a regional team. As one of the world’s largest insurance brokers — and a proud Stevie Award-winning workplace — HUB offers a unique blend of big-company resources and entrepreneurial spirit. With over 20,000 professionals across 570+ offices in North America, we bring...

The Appeals Team Lead assists injured workers, claims examiners, attorneys, providers, etc. in locating providers within the medical provider network (MPN), verifying provider inclusion in an MPN and scheduling appointments upon request for the injured worker. This position includes a moderate volume of inbound calls and a high volume of outbound calls. This role is responsible for documenting bill review errors to improve team error rate trend. The Provider Relations Specialist acts as a positive and professional representative of our CorVel family. The role ensures compliance with company best practice standards while also enabling a consistent, timely delivery of our quality services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receive incoming calls, emails and faxes from the Medical Access Assistant line Communicate clearly and professionally with providers and other stakeholders via phone and email Provide excellent customer service...