Workers Compensation Claims Representative III
Location
Worldwide
Posted
31 days ago
Salary
$52K - $78K / year
Seniority
Senior
No structured requirement data.
Job Description
Workers Compensation Claims Representative III
MEM Insurance
Title: Workers' Compensation Claims Representative III (Remote) Location: Kansas City, MO, USA Job Description: Are you an experienced claims professional ready to take on complex cases and make a meaningful impact? MEM Insurance is seeking a seasoned Claims Representative to join our dynamic Claims team. In this role, you will manage a caseload of high-exposure workers’ compensation claims, oversee advanced medical case management, and develop tailored Return-to-Work plans. You’ll collaborate with vocational consultants, legal counsel, and internal teams to ensure compliance, negotiate settlements, and deliver exceptional service to our policyholders. This position offers the opportunity to work independently while providing leadership on complex claims and contributing to workflow improvements. Essential Duties and Responsibilities - Manage complex workers’ compensation claims involving high financial exposure, sensitive issues, or extended life cycles. - Investigate coverage and compensability, ensuring thorough documentation and compliance with state statutes. - Oversee advanced medical case management, including coordination with Nurse Case Managers and external vendors. - Develop and implement Return-to-Work plans for high-risk claims, collaborating with vocational consultants and legal counsel. - Identify and investigate potential fraud and subrogation opportunities, partnering with the Special Investigation Unit. - Establish and maintain accurate claim reserves within authority levels, ensuring timely responsiveness to changing circumstances. - Evaluate and negotiate settlements within approved authority levels, including structured settlements and Medicare compliance. - Collaborate with legal counsel to manage litigation and ensure adherence to MEM guidelines. - Maintain accurate system data and prepare reports for management on high-profile claims. - Foster cross-departmental collaboration with Underwriting, Premium Consultation, and Loss Prevention. - Provide mentorship and training to junior adjusters, supporting professional growth and team development. Qualifications - High school diploma or equivalent required; bachelor’s degree preferred. - Associate in Claims (AIC) designation preferred. - Valid driver’s license required; Texas-All Lines license preferred. - 3–5 years of claims handling experience, primarily in Workers’ Compensation. Missouri experience preferred. Company Culture and Values At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered. Diversity Statement MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities. Total Rewards Overview - Health Plans: Medical, Dental, and Vision Includes fertility benefits, fully paid preventative care, and adult orthodontia. - Employer-Paid Life and Disability Benefits: Life Insurance (3x base salary), AD&D, Short and Long-term Disability. - Wellness and Recognition Program: Employer-paid incentives for employees and spouses. - Flexible Spending Account and Dependent Care options - Health Savings Account: Generous employer contribution. - Time Away from Work: Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave. - Employee Assistance Programs - 401k Retirement Plan: Employer match and profit sharing. - Adoption Assistance and Tuition Assistance Notice Regarding Use of Artificial Intelligence MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws. Job Details Pay Type Salary Hiring Min Rate 52,000 USD Hiring Max Rate 78,000 USD
Related Guides
Related Categories
Related Job Pages
More Claims Specialist Jobs
Claims Advocate
Alliant Insurance ServicesAlliant Insurance Services is a prominent insurance brokerage firm dedicated to delivering comprehensive risk management and employee benefits solutions, includ
Title: Claims Advocate Location: Virtual•United States Req #4963 Job Description: Alliant Insurance Services is one of the nation’s largest and fastest-growing insurance brokerage and consulting firms. We operate through a network of specialized national platforms and local offices to offer our clients a comprehensive portfolio of solutions built on innovative thinking and personal service. Alliant is changing the way our clients approach risk management and benefits, so they can capitalize on new opportunities to grow and protect their organizations. SUMMARY Responsible for providing customer service and supporting Producers by servicing existing accounts and soliciting new business. Independent responsibility for managing medium and complex claims of assigned clients. ESSENTIAL DUTIES AND RESPONSIBILITIES Acts as an advocate and claims specialist to provide support to clients, claimants, Producers, and carriers; Provides initial and on-going advocacy on claims including detailed analysis, interpretation, consultation and negotiation of coverage and reserves; Provides assistance on complex, large claims issues; Reports to carriers on property, liability, litigated, high exposure and specialty claims; Maintains claim diaries and reviews reservations of rights of denials; Travels to loss sites to assist clients with the claim process; Meets with clients and internal staff to provide analysis, interpretation and recommendations regarding client loss information; Responds to clients and Producers regarding coverage, exposure, and settlement questions; Manages subrogation and recovery situations by working closely with client; Prepares coverage arguments for client advocacy and form coverage positions as client advocate; Works with client legal counsel on coverage, claims and strategy for settlement; Assists client with case preparation and support as needed, using negotiation skills to provide best possible outcome for clients; Provides value added services to Producers, focusing on account retention and obtaining new business; Develops training materials with a client and service team perspective for coverage reviews, loss reporting procedures, and claims guidelines in handling various situations; Conducts quarterly claims review meetings with employer representatives; Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information); Other duties as assigned. QUALIFICATIONS EDUCATION / EXPERIENCE Bachelor’s degree or equivalent combination of education and experience Six (6) or more years related work experience, brokerage or insurance carrier experience preferred Possession of CPCU, AIC and/or ARM preferred Valid Fire and Casualty Broker – Agent license In depth knowledge of all commonly encountered P&C insurance coverage and Risk Management concepts and techniques SKILLS Excellent verbal and written communication skills Ability to work within a team and to foster teamwork Excellent customer service skills, including telephone and listening skills Great leadership, problem solving and time management skills Advanced analytical skills Ability to interface with internal and external executives Proficient in Microsoft Office Suite #LI-JP1 #LI-REMOTE We are proud to provide comprehensive, high quality employee programs to meet employees' needs now and in the future, including a very competitive financial package. We encourage you to explore what we have to offer. Alliant Insurance Services, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment based on their qualifications and ability without regard to race, color, religion, sex (including pregnancy, childbirth, breastfeeding, sexual orientation, and gender identity), national origin, ancestry, physical or mental disability, medical condition, marital status, age, genetic information, or status as a protected veteran, in accordance with applicable federal, state, and local laws, including California law. Pay Type Salary Hiring Min Rate 80,000 USD Hiring Max Rate 90,000 USD
Loss Mitigation Associate
Hyundai Capital AmericaHeadquartered in Irvine, California, Hyundai Capital America is an automobile finance company that offers lending and financial products for individuals and businesses. More than 1
Title: Loss Mitigation Associate Location: Plano United States Job Description: Who We Are Through our service brands Hyundai Motor Finance, Genesis Finance, and Kia Finance, Hyundai Capital America offers a wide range of financial products tailored to meet the needs of Hyundai, Genesis, and Kia customers and dealerships. We provide vehicle financing, leasing, subscription, and insurance solutions to over 3 million consumers and businesses. Embodying our commitment to grow, innovate, and diversify, we strive to reimagine the customer and dealer experience and launch innovative new products that broaden our market reach. We believe that success comes from within and are proud to support our team members through skill development and career advancement. Hyundai Capital America is an Equal Opportunity Employer committed to creating a diverse and inclusive culture for our workforce. We are a values-driven company dedicated to supporting both internal and external communities through volunteering, philanthropy, and the empowerment of our Employee Resource Groups. Together, we strive to be the leader in financing freedom of movement. We Take Care of Our People As an employee of HCA, you are eligible for the following benefits: - Role is 100% remote (after in-office new hire training) - Competitive pay-$24.40 an hour plus up to $2,250 in monthly bonuses! - Great benefits with very little out of pocket cost! - Car purchase discount plus $350.00 car allowance! - Medical, dental, and vision plans with no-cost and low-cost options - Annual employer HSA contribution - 401(k) matching and immediate vesting - Vehicle purchase and lease discounts, plus monthly vehicle allowances by job level: o Associate / Sr. Associate: $350 o Manager / Sr. Manager: $600 o Director: $800 o Executive Director: $900 o VP or Above: $1,000 - 100% employer-paid life and disability insurance - No-cost health and wellbeing programs, including a gym benefit - Six weeks of paid parental leave - Paid Volunteer Time Off, plus a company donation to a charity of your choice What to Expect The Associate, Loss Mitigation is primarily responsible for managing a queue of delinquent accounts 80 days past due through charge off by investigating, monitoring and resolving accounts. The position will comply with internal policy and procedures on handling all accounts. All positions within the Operations Division are expected to collaborate cross divisionally to achieve a seamless customer experience; this includes supporting other departments as necessary to meet the business need. Training will be onsite for the first six weeks. After the training, the role would be remote will a one-day per month onsite day. What You Will Do - Manage a queue of delinquent 80 days past due accounts. Handle inbound and outbound calls as needed per position. Ensure all account activity is properly documented per department standards. Adhere to department standards for effective queue management. - Performance Coaching - Actively participate in coaching and development sessions/trainings to co-create solutions that enhance individual performance and overall department/team performance. - Perform all other duties as assigned. What You Will Bring - 1-2 years collection or relevant experience (automotive preferred) - Previous experience in late-stage collections is preferred - High school graduate or GED equivalent - Bachelor's degree preferred - Ability to independently manage their time daily to ensure productivity and goals are met - Strong negotiation skills - Ability to negotiate mutually beneficial arrangements with the customer - Skip tracing skills - Ability to utilize various skip tracing tools (where applicable) - Basic computer skills - Knowledge of Windows including Word and Excel - Strong communication skills - Ability to clearly communicate thoughts and ideas to peers and customers - Strong negotiation skills - Ability to negotiate mutually beneficial arrangements with the customer - Strong listening skills - Ability to listen and understand direction Work Environment Employees in this class are subject to extended periods of sitting, standing and walking, vision to monitor and moderate noise levels. Work is performed in an office environment. The posted salary range for this job takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; geographic location, and other business and organizational needs. Successful candidates may be hired anywhere in the salary range based on these factors. It is uncommon to hire candidates at or near the top of the range. California Privacy Notice This notice only applies to our applicants who reside in the State of California. The latest version of our Privacy Policy can be found here. This Privacy Policy provides you with notice, at or before the point of collection, about the categories of personal information to be collected from you, the purposes for which your personal information is collected or used, and whether that information is sold or shared, so that you can exercise meaningful control over our use of your personal information. We are providing this notice to comply with the California Consumer Privacy Act of 2018, as amended as amended by the California Privacy Rights Act of 2020 ("CCPA"). If you have any questions about CCPA regarding California residents or HCA team members, please contact the Privacy Team at Privacy2@hcs.com.
Title: Property/Casualty Agency Service Specialist Location: Urbandale Iowa US Department: 0.25 Job Description: Description: Midwest Family Mutual is a Property/Casualty Insurance Company looking for an experienced, customer focused individual to join our Agent Service Center team! This position is responsible for accurate and timely data entry/application processing, while providing excellent customer service to our independent agents and insureds. Qualified candidate will have a minimum of 3 years property/casualty insurance experience, with a strong emphasis in commercial lines, customer service and heavy call environment. This is a remote (work from home) desk position and requires someone who works well independently as well as part of a remote team environment. A dedicated home office space, wired high speed internet connection is required. Midwest Family has maintained a remote work environment since 2006 with no intentions of bringing employees back into a physical office. *Work hours for this position are 9:00am – 6:00pm CT; Monday – Friday, with occasional overtime. Responsibilities include, but are not limited to, the following: *Other functions may be assigned as business conditions change. - Timely review and processing of commercial quotes and new business applications. - Answer billing questions and process payments for customers. - Assist agents as needed through various means including incoming calls, email, live chat/instant messaging. - Assist agents with personal lines changes and quotes. - Work closely with the Underwriting and Marketing departments, and other areas within the company to deliver upon our mission statement. - Provide exceptional customer service and quality of work in a fast-paced environment. Requirements: - Strong written and verbal communication skills with the ability to communicate effectively to a variety of audiences. - Excellent customer service and call center experience required. - Strong organizational skills and attention to detail. - 3+ years of P&C Insurance experience required. - Excellent data entry skills. - Must be able to work independently and be self-motivated. - Create and maintain a high-quality work environment. - This is a full-time, remote position that will require dependable high-speed cable/DSL Internet, a dedicated home office space and travel to the IA office on occasion. - Ability to work until 7:00PM CST and have the flexibility to occasionally work during the hours of 7am - 7pm to cover PTO Education/Training/Experience: - High School Diploma or General Education Degree (GED) - Property/Casualty Insurance knowledge and experience - Insurance education/designations is a plus – i.e. INS, CPCU, CIC PI368f7eac70c3-29963-40356163
Mortgage Specialist
ManulifeManulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better.
Title: Mortgage Specialist, Manulife Bank (Prairies Region) Location: Alberta, Full Time Remote CAN, Manitoba - Full Time Remote CAN, Saskatchewan - Full Time Remote Job Description: time type Full time job requisition id JR26040688 Are you someone who thrives in a busy role that engages both your analytical, problem-solving skills and customer-focused approach? Do you enjoy establishing relationships and using your skills to offer financial solutions to help clients achieve their broader financial goals? Our Manulife Bank team in the Prairies region has an immediate opportunity for a Mortgage Specialist. As a Mortgage Specialist, you will be responsible for selling Manulife Bank financial solutions directly to existing Manulife Bank clients in collaboration with financial advisors within a specified territory. This is an exciting and rewarding work-from-home opportunity! Who are we looking for? You are a consultative and engaging ambassador for our Bank products who knows how to get things done while maintaining and encouraging meaningful relationships. You are a self-starter who knows what consistent activities and communication habits lead to successful sales. You contribute by bringing your banking knowledge, positive energy, passion and attention to service into the regional marketplace by helping others understand that not all mortgages are created equally and that there's more to a mortgage than simply interest rate. Position Responsibilities: - Sell and promote Manulife One, Manulife Bank Select and ancillary products based on robust client conversations focused on understanding client needs and goals. - Ensure efficient and flawless delivery to the client and flow of business is directed to the appropriate servicing unit. - Act as a conduit for feedback from the field by identifying ideas for improving existing products and services and new product opportunities. - Build relationships with key advisors to ensure they remain strong partners of Manulife bank. Required Qualifications: - Proven track record of high performance within a busy mortgage sales environment. - Inherent drive to build your process and communication habits that will make you a sales-leader on the team. - High energy and self-motivation combined with a positive attitude that thrives in an industry that experiences regular change. - Solid underwriting experience with residential mortgages (3-5 years). - 5 or more years of fast-paced financial services experience is preferred. - Solid communication habits and skills. Preferred Qualifications: - Proven consultative sales capability – including establishing a relationship with the client, conducting needs analysis and presenting solutions with strong closing and servicing skills. - Aptitude and drive for self-learning and use of technology for business purposes and to improve efficiencies. - Outstanding oral and written communication skills to translate complex technical issues and business definitions into concepts and procedures readily understood and accessible to a general audience. - Analytical and decision-making skills with an ability to calmly prioritize a variety of tasks when the workload is heavy and deadlines are pending. - Effective change management and organizational skills in order to manage fluctuating workloads and changes in policy. - Excellent customer and relationship management skills. - Highly developed influencing and negotiation skills. When you join our team: - We’ll empower you to learn and grow the career you want. - We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words. - As part of our global team, we’ll support you in shaping the future you want to see. Special Condition: - The role is 100% commission based. If you have a passion for sharing knowledge, providing advice and offering support with a focus on providing outstanding customer solutions, we want to meet you! The role being advertised is an existing vacancy. About Manulife and John Hancock Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html. Manulife is an Equal Opportunity Employer At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law. It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact hr Working Arrangement Remote Salary & Benefits Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. If you are applying for this role outside of the primary location, please contact hr for the salary range for your location. Manulife offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in Canada includes holidays, vacation, personal, and sick days, and we offer the full range of statutory leaves of absence. If you are applying for this role in the U.S., please contact hr for more information about U.S.-specific paid time off provisions. We use data and analytics technologies, such as artificial intelligence (AI), and automated processing tools, to analyze and process the information you provide to us or third parties in the application process. For more information, please refer to our personal information collection statement.
