Senior Workers Comp Claims Specialist

• Manage a large inventory of highly complex claims to evaluate compensability and liability
• Lead comprehensive claims investigations to confirm coverage and determine liability, compensability, and damages
• Analyze and negotiate claim settlements and reserves within prescribed authority
• Attend arbitrations, mediations, depositions, or trials as needed
• Convey complex coverage and settlement information to insureds, claimants, and external partners
• Authorize payments within assigned authority limits and ensure timely disbursement
• Maintain accurate and detailed claim files, including correspondence, reports, and settlement agreements
• Potentially coach staff and participate in talent selection, development, and performance management decisions
• Perform other duties as assigned

Requirements

• Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field or equivalent experience
• Generally, a minimum of 13 years of experience in property and casualty claims handling
• Completion of or continuing progress toward a professional designation such as Associate in Claims (AIC) preferred
• California workers’ compensation experience preferred
• Excellent analytical, negotiation, and problem-solving skills
• Expert knowledge of insurance policies, coverage, and claims handling procedures
• Knowledge of industry laws and regulations
• Advanced ability to organize and prioritize caseloads
• Excellent interpersonal and communication skills
• Ability to build relationships and lead negotiations
• Proven ability to handle confidential information with discretion
• Must be authorized to work in the United States without the need for current or future sponsorship

Core Competencies

Demonstrates expertise in managing complex claims, including evaluating compensability and liability, negotiating settlements, and ensuring compliance with industry regulations. Strong analytical and communication skills are essential for conveying complex information and leading negotiations effectively.

Highest-signal resume keywords

• Claims Management
• Negotiation Skills
• Insurance Policy Knowledge
• Analytical Skills
• California Workers' Compensation Experience

Hard Skills

• Claims Handling
• Compensability Evaluation
• Liability Assessment
• Settlement Negotiation
• Claims Investigation
• Claims File Management
• Regulatory Compliance
• Risk Management
• Financial Analysis
• Problem Solving

Soft Skills

• Interpersonal Skills
• Communication Skills
• Relationship Building
• Coaching
• Organizational Skills

Certifications & Qualifications

• Bachelor's Degree
• Associate in Claims (AIC)

Industry Keywords

• Property and Casualty Claims
• Insurance Coverage
• Claims Procedures
• Confidential Information Management
• Arbitration
• Mediation
• Depositions
• Trial Experience
• Claims Reserves
• Talent Development