Sr. Workers' Compensation Claims Adjuster | Remote Work from home Job at KING'S INSURANCE STAFFING LLC, Philadelphia, PA

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  • KING'S INSURANCE STAFFING LLC
  • Philadelphia, PA

Job Description

Job Description

Job Description

Our client, an 'A' rated Insurance Carrier, is currently seeking an experienced Senior Workers' Compensation Claims Examiner with a proven track record in managing moderate to complex claims in Pennsylvania. This role requires a professional with experience in workers' compensation claims, who is adept at handling complex litigated and non-litigated Pennsylvania Lost Time with a focus on quality and efficiency. Our client is open to candidates working fully remote.

Key Responsibilities:

  • Responsible for handling a caseload of 80 - 85 Lost Time Pennsylvania Workers' Compensation claims from inception to close.

  • Negotiate settlements and authorize payments within delegated limits.

  • Ensure compliance with all state regulatory requirements and internal policies.
  • Communicate effectively with policyholders, medical professionals, employers, and legal counsel to gather information and resolve claims.
  • Maintain accurate records and prepare reports for management regarding claim status and resolution.
  • Attend hearings, mediations, and other legal proceedings as required.
  • Provide guidance and training to junior claims staff and support their development.

Qualifications:

  • 7+ years of experience as a Workers' Compensation Claims Examiner with a deep understanding of Pennsylvania Workers' Compensation Law

  • Insurance Carrier experience is required

  • Experience and strong knowledge in New Jersey Workers' Compensation Law is a plus

  • Strong understanding of Pennsylvania EDI processes and transactions.

  • Effective organizational skills and ability to work independently

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

Salary/Benefits:

  • $95,000 to $110,000+ base salary plus Annual Bonus

  • Employer matching 401(k) plan

  • Extremely competitive Medical, Dental, Vision and Life plans

  • Employer Contribution to HSA

  • Generous PTO

  • Flexible work schedule and ability to work from home

Job Tags

Remote job, Flexible hours,

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