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WC Claims Representative (Hybrid/Remote)

Remote, USA Full-time Posted 2025-11-03
About the position The Workers Comp Claims Representative at Selective Insurance is responsible for managing lost-time claims, ensuring effective communication with all parties involved, and making timely decisions regarding coverage and compensability. This hybrid role allows for a combination of in-office and remote work, focusing on providing excellent customer service while adhering to regulatory guidelines. Responsibilities • Receive assigned lost-time claims for investigation to determine coverage and compensability on claims with a short disability period of 8 weeks or less. , • Process claims which include making contacts, setting reserves, establishing files in MCS, evaluating exposure, and establishing initial and subsequent reserves on less severe claims. , • Document claim files and maintain control of work through documentation or diary system. , • Handle non-litigated claims only. , • File state forms timely in accordance with statutory guidelines. , • Collaborate with nurses and vendors on medical and disability management. , • Prepare for and participate in claims review and settlement conferences. , • Ensure compliance with company, state and federal regulations. Requirements • 1 year of experience in claims management or a related field. , • Less than high school education. Nice-to-haves • Experience in the insurance industry. , • Familiarity with workers' compensation claims processes. Benefits • Comprehensive health care plans. , • Retirement savings plan with company match. , • Discounted Employee Stock Purchase Program. , • Tuition assistance and reimbursement programs. , • Paid time off plans. Apply Job!  

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