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The Jonus Group

WC Claims Representative

The Jonus Group, Omaha, Nebraska, us, 68197

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WC Claims Representative

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Job Summary This position is for an experienced

Workers' Compensation (WC) Claims Representative

to manage lost time claims. The role involves working remotely to handle claims from multiple jurisdictions, including North Carolina, South Carolina, and Tennessee. The successful candidate will be responsible for evaluating compensability, negotiating settlements, and overseeing the entire claims process while maintaining consistent communication with stakeholders.

Responsibilities

Determine compensability and coverage issues for lost time workers' compensation claims.

Effectively manage a caseload of lost time claims across multiple jurisdictions (NC, SC, TN).

Negotiate and direct settlements with management review.

Gather medical and factual evidence to assess compensability.

Direct external investigations and handle litigation files within given authority.

Maintain regular contact with claimants, attorneys, outside investigators, rehabilitation personnel, and medical providers.

Collaborate with insureds, account liaisons, and other stakeholders to ensure claims are managed efficiently.

Qualifications/Requirements

Minimum of three years of experience handling workers' compensation claims.

Experience managing claims in North Carolina, South Carolina, and/or Tennessee.

Bachelor's degree required.

Carrier experience is preferred.

Proven experience handling lost time or litigated claims.

Familiarity with medical terminology.

Strong organizational, problem-solving, negotiation, and conflict resolution skills.

Excellent verbal and written communication skills.

Compensation Package

Salary: $70K - $87K per year (based on experience).

Competitive benefits package, paid time off, professional development opportunities, etc.

Fully remote work schedule.

Additional Information Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

Job Details

Seniority level: Mid-Senior level

Employment type: Full-time

Job function: Sales, Business Development, and Finance

Industries: Banking, Financial Services, and Insurance

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