Job Description

Job Description

Job Title: Workers’ Compensation Indemnity Specialist

RESPONSIBILITIES:

• We are seeking an experienced Indemnity Claims Specialist to manage a complex workers’ compensation desk with a strong emphasis on Pennsylvania lost-time and litigated claims . This role handles primarily indemnity and complex files, with limited medical-only exposure, and requires collaboration with internal leadership and external stakeholders to ensure high-quality, compliant claim outcomes. Manage a caseload of approximately 135 open indemnity and complex workers’ compensation claims , including lost-time files
• Handle a desk that is at least 50% litigated , working closely with defense attorneys
• Demonstrate strong working knowledge of Pennsylvania Workers’ Compensation regulations and practices
• Apply New Jersey and Delaware jurisdictional knowledge as required by assigned files
• Investigate claims, determine compensability, establish reserves, and manage ongoing exposure
• Coordinate medical care, wage loss benefits, and return-to-work efforts
• Communicate effectively with all stakeholders, including attorneys, injured workers, employers, carriers, and medical providers
• Utilize claims management systems to document activity, manage workflows, and meet service expectations
• Adhere to quality standards, production benchmarks, and client service level agreements (SLAs)
• Participate in internal reviews, audits, and performance evaluations
• Performance Measures Compliance with quality and accuracy standards
• Meeting production expectations for claim handling and resolution
• Adherence to client service level agreements (SLAs)
• Stakeholders External: Defense attorneys, injured workers, employers, clients, carriers, medical providers
• Internal: Supervisor, Manager, Account Manager

QUALIFICATIONS:

• Experience & Knowledge2–3 years of workers’ compensation claims experience , with a strong focus on indemnity and lost-time claims
• Extensive Pennsylvania workers’ compensation experience required
• New Jersey claims experience required
• Delaware experience preferred and may be eligible for additional consideration
• Prior experience handling litigated claims is required
• Licenses & Education Delaware Adjuster’s License required
• Assistance available to obtain license within 120 days , if not currently held
• Reciprocal licenses (Florida or Texas) accepted
• Bachelor’s degree or equivalent relevant work experience
• Technical Skills Proficiency in Microsoft Office (Teams, Outlook/Email, Word)
• Experience using CareMC claims system preferred (not required)
• Strong documentation, organization, and time-management skills

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