RLI Insurance Company
Workers' Compensation Claim Monitoring Specialist (Part-Time)
RLI Insurance Company, Chicago, Illinois, United States, 60290
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Workers' Compensation Claim Monitoring Specialist (Part-Time)
role at
RLI Insurance Company
RLI is a Glassdoor Best Places to Work company with a strong track record. This part-time role focuses on oversight rather than direct handling of workers’ compensation (WC) claims. The WC Claim Oversight Specialist will monitor the performance and decision-making of the external third-party administrator (TPA) with a focus on higher exposure WC claims, ensuring claim strategies, reserve practices, and resolution paths align with RLI’s standards, mitigate risk, and support optimal outcomes.
The Claim Oversight Specialist will not direct handle claims in this part-time role. Instead, this role monitors and helps direct the quality and strategy of the TPA’s adjustment of WC claims.
Principal Duties & Responsibilities
Review higher exposure WC claims managed by the TPA to ensure compliance with legal requirements and RLI's standards, expectations, and strategic direction.
Identify, address, and escalate concerns related to reserve adequacy, litigation strategy, medical management, and settlement positioning.
Review new claims for assignment and confirmation of coverage.
Partner with TPA claim handlers and leadership to ensure WC claims are timely administered and resolved, including review and approval of reserve requests above TPA’s authority.
Coordinate and collaborate with RLI Claim operations staff on the setup, processing, payment, and resolution of WC claims.
Provide timely feedback to internal stakeholders on WC claim handling performance, opportunities for improvement, and potential risks.
Collaborate with internal claim leadership to support file audits or performance reviews of the TPA.
Communicate with underwriters regarding WC claims and industry trends.
Maintain awareness of regulatory or jurisdictional requirements that may impact WC claim strategy or handling.
Support special projects related to TPA, claim quality, or claim data review as needed.
Education & Experience
Typically requires a bachelor’s degree in business administration, insurance, or a related field
6+ years of related experience handling WC claims, with exposure to complex and litigated files
[OR] equivalent level of education and experience
Experience with vendor-managed claims or quality assurance oversight is a strong plus
Knowledge, Skills, & Competencies
Ability to proactively and strategically assess WC claims and the TPA’s claim management
Strong analytical and critical thinking skills with the ability to evaluate claim handling against WC legal requirements and standards
Clear written and verbal communication skills for summarizing claim concerns and recommendations
High attention to detail and a proactive approach to identifying potential issues
Ability to work independently and manage time effectively in a flexible, part-time arrangement
Familiarity with jurisdictional nuances in WC and best practices for vendor management
Compensation Overview The base salary range for the position is listed below. The base salary is one component of the total rewards package at RLI. The salary offered will consider factors including geographic location, experience, scope & responsibilities, qualifications, talent availability, and business needs.
Base Pay Range $59,591.00 - $83,577.00
Total Rewards RLI offers employee ownership through ESOP and a comprehensive rewards program including compensation, benefits and perks.
Annual bonus plans
Employee stock ownership plan (ESOP)
401(k) with automatic 3% company contribution
Profit-sharing contributions (up to 15% of eligible earnings)
Work & Life, Health & Wellness, Personal & Professional Growth
Paid time off (PTO) and holidays
Paid volunteer time off (VTO) and parental/family care leave
Flexible & hybrid work arrangements
Wellness benefits and health coverage
Tuition reimbursement and professional development opportunities
Diversity & Inclusion RLI is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by law.
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
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Workers' Compensation Claim Monitoring Specialist (Part-Time)
role at
RLI Insurance Company
RLI is a Glassdoor Best Places to Work company with a strong track record. This part-time role focuses on oversight rather than direct handling of workers’ compensation (WC) claims. The WC Claim Oversight Specialist will monitor the performance and decision-making of the external third-party administrator (TPA) with a focus on higher exposure WC claims, ensuring claim strategies, reserve practices, and resolution paths align with RLI’s standards, mitigate risk, and support optimal outcomes.
The Claim Oversight Specialist will not direct handle claims in this part-time role. Instead, this role monitors and helps direct the quality and strategy of the TPA’s adjustment of WC claims.
Principal Duties & Responsibilities
Review higher exposure WC claims managed by the TPA to ensure compliance with legal requirements and RLI's standards, expectations, and strategic direction.
Identify, address, and escalate concerns related to reserve adequacy, litigation strategy, medical management, and settlement positioning.
Review new claims for assignment and confirmation of coverage.
Partner with TPA claim handlers and leadership to ensure WC claims are timely administered and resolved, including review and approval of reserve requests above TPA’s authority.
Coordinate and collaborate with RLI Claim operations staff on the setup, processing, payment, and resolution of WC claims.
Provide timely feedback to internal stakeholders on WC claim handling performance, opportunities for improvement, and potential risks.
Collaborate with internal claim leadership to support file audits or performance reviews of the TPA.
Communicate with underwriters regarding WC claims and industry trends.
Maintain awareness of regulatory or jurisdictional requirements that may impact WC claim strategy or handling.
Support special projects related to TPA, claim quality, or claim data review as needed.
Education & Experience
Typically requires a bachelor’s degree in business administration, insurance, or a related field
6+ years of related experience handling WC claims, with exposure to complex and litigated files
[OR] equivalent level of education and experience
Experience with vendor-managed claims or quality assurance oversight is a strong plus
Knowledge, Skills, & Competencies
Ability to proactively and strategically assess WC claims and the TPA’s claim management
Strong analytical and critical thinking skills with the ability to evaluate claim handling against WC legal requirements and standards
Clear written and verbal communication skills for summarizing claim concerns and recommendations
High attention to detail and a proactive approach to identifying potential issues
Ability to work independently and manage time effectively in a flexible, part-time arrangement
Familiarity with jurisdictional nuances in WC and best practices for vendor management
Compensation Overview The base salary range for the position is listed below. The base salary is one component of the total rewards package at RLI. The salary offered will consider factors including geographic location, experience, scope & responsibilities, qualifications, talent availability, and business needs.
Base Pay Range $59,591.00 - $83,577.00
Total Rewards RLI offers employee ownership through ESOP and a comprehensive rewards program including compensation, benefits and perks.
Annual bonus plans
Employee stock ownership plan (ESOP)
401(k) with automatic 3% company contribution
Profit-sharing contributions (up to 15% of eligible earnings)
Work & Life, Health & Wellness, Personal & Professional Growth
Paid time off (PTO) and holidays
Paid volunteer time off (VTO) and parental/family care leave
Flexible & hybrid work arrangements
Wellness benefits and health coverage
Tuition reimbursement and professional development opportunities
Diversity & Inclusion RLI is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by law.
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr