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Claims Specialist - Workers' Compensation


CA - San Francisco

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General Description: Manage claim administration functions for clients of the business.



  • Conducts claim reviews and negotiates with carriers for claim services.
  • Advanced understanding of at least two lines of coverage relative to claims management strategies, resolution techniques & coverage forms ( generally WC & Liability)
  • Ability to use carrier / TPA claims management systems to generate reports that provide loss information and some level of trends / analytics.
  • Ability to identify client issues, build a plan towards resolution, execute and manage internal and external expectations effectively.
  • Understanding of loss ratios and general understanding of loss impact on premium.
  • Higher-level technical administrative ability with use of Microsoft Suite, ability to produce user friendly documents through internal resources.
  • Strength in communication internally and with clients at various levels within the client organization.
  • Plan and organize workflow and meetings with clients in an independent manner.
  • Responsible for claim advocacy and negotiation, including claim denial review, reservation of rights review, and claim reporting.
  • Analyzes claims based on a best practice outline and partners with other members of the technical resource team.
  • Responsible to assist members of the USI team with "Close" and "Keep".

Knowledge, Skills and Abilities:

  • Superior written and oral communication skills.
  • Ability to work well in a team environment.
  • Must have strong analytical thinking and problem-solving skills.
  • Strong organizational skills required.
  • Strong negotiation skills required.
  • Ideal candidate will have a minimum of three to five year of claims administration experience.
  • College degree preferred but high school diploma or graduate equivalent degree required.
  • Proficient-to-expert in MS Office suite of products.

Job ID:


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