Workers' Compensation Specialist

Workers’ Compensation Claims Specialist (Remote)

Location: Remote (Central Time Zone Preferred)

Territory: Indiana, Illinois, Kentucky, and Michigan

Start Date: ASAP

We are seeking an experienced Workers’ Compensation Claims Specialist to join a leading third-party claims administration organization. This role is responsible for managing complex, high-exposure workers’ compensation claims while ensuring compliance with applicable state regulations and delivering exceptional client service.

Responsibilities

• Manage a caseload of complex workers’ compensation indemnity claims from inception through resolution.
• Determine compensability, benefits eligibility, and appropriate claim strategies within delegated authority levels.
• Collaborate with nurse case managers, attorneys, employers, medical providers, and injured workers throughout the claims process.
• Investigate claims, evaluate exposures, and develop resolution strategies to achieve optimal outcomes.
• Manage subrogation opportunities and negotiate settlements when appropriate.
• Maintain accurate claim documentation and ensure compliance with jurisdictional requirements.
• Provide timely communication and superior customer service to internal and external stakeholders.

Required Qualifications

• Minimum 3 years of workers’ compensation claims handling experience.
• Strong experience managing indemnity claims.
• Experience handling claims in at least two of the following jurisdictions:
• Indiana (IN)
• Illinois (IL)
• Kentucky (KY)
• Michigan (MI)
• Active workers’ compensation adjuster license in KY, IN, or MI, or a reciprocal license that allows handling claims in these states.
• Strong knowledge of workers’ compensation laws, regulations, and claims management practices.
• Excellent negotiation, communication, and organizational skills.