Workers' Compensation Claims Representative in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Workers' Compensation Claims Representative in the United States.

This role is a fully remote opportunity focused on managing end-to-end workers’ compensation claims across multiple jurisdictions. You will play a key part in evaluating claim validity, determining compensability, and guiding cases through resolution while ensuring compliance with applicable regulations. The position requires strong investigative and analytical skills, as you will gather medical and factual evidence, coordinate with external stakeholders, and manage both litigated and non-litigated claims. You will act as a central point of contact for claimants, attorneys, providers, and internal teams, ensuring clear communication and efficient case progression. This is a high-responsibility role where your decisions directly impact claim outcomes, cost control, and claimant experience. It offers exposure to complex, multi-state claims work within a structured and supportive remote environment.

• Manage a caseload of lost-time workers’ compensation claims across multiple jurisdictions, ensuring accurate and timely handling of each file.
• Determine compensability and coverage by analyzing medical records, factual evidence, and policy information.
• Coordinate investigations and manage litigation files, directing external investigators and legal resources as needed.
• Negotiate and support claim settlements within delegated authority, ensuring fair and compliant resolutions.
• Maintain ongoing communication with claimants, attorneys, medical providers, rehabilitation professionals, and insured clients.
• Collaborate with internal stakeholders and account teams to ensure alignment and efficient claims resolution.
• Document and track all claim activity accurately in accordance with regulatory and organizational standards.

This role requires a detail-oriented claims professional with strong analytical and communication skills, capable of managing complex, multi-jurisdictional workers’ compensation cases. The ideal candidate brings hands-on carrier experience, strong organizational ability, and confidence handling both litigated and lost-time claims.

• Minimum 3 years of experience with an insurance carrier in workers’ compensation claims handling.
• Experience managing lost-time and/or litigated claims across multiple jurisdictions, including TN, GA, NC, SC, and AL.
• Bachelor’s degree required.
• Strong understanding of medical terminology and claims documentation.
• Excellent negotiation, conflict resolution, and problem-solving skills.
• Strong organizational skills with the ability to manage multiple active cases simultaneously.
• Clear and professional verbal and written communication skills.
• Ability to work independently in a fully remote environment while maintaining productivity and accuracy.

• Competitive annual salary range: $80,000 – $95,000
• Medical, dental, vision, life, and disability insurance coverage
• Enhanced dental plan with orthodontia coverage
• Generous paid time off and paid company holidays, plus floating holidays
• Paid parental leave
• 401(k) retirement plan with company match and immediate vesting
• Tuition reimbursement program (eligible after 6 months of service)
• Wellness programs including fitness reimbursement and health initiatives
• Employee discounts on travel, electronics, entertainment, and more
• Service recognition rewards every 5 years of employment
• Voluntary benefits including accident, critical illness, and hospital indemnity coverage
• Fully remote work flexibility within the continental United States