Claim Specialist II or III-NJ and PA

Location: Remote
Company: MEMIC – Trusted Workers’ Compensation Insurance Provider

About MEMIC

At MEMIC, our mission is to make workers’ compensation insurance better—through compassionate service, trusted partnerships, and an unwavering focus on workplace safety. Our core values—Be Conscientious, Be an Expert, Be a Partner, Be Curious, and Be Transparent—drive everything we do. For over 30 years, we’ve been a leader in helping businesses protect their employees and reduce workplace injuries while delivering exceptional claims services.

Job Overview: Claim Specialist II or III NJ & PA Jurisdictions

The Claim Specialist investigates, evaluates, negotiates, and resolves lost time claims within settlement and reserving authority up to stated maximum. (Supervisor will determine actual individual authority up to the stated maximum). Conducts training classes (including research and position papers) for less experienced Claim Department Representatives. Based on experience and proven ability, an expanded and more difficult caseload will be expected, requiring a lesser degree of supervision.

Key Responsibilities

• Claims Management: Investigate, evaluate, negotiate and resolve medical-only and lost time claims within settlement and reserving authority up to stated maximum.

• Communication: Serve as a point of contact for insureds, injured workers, agents, brokers, attorneys, and other stakeholders to gather necessary information and provide timely updates.

• Benefit Delivery: Administer medical and indemnity benefits in compliance with NJ and PA state workers’ compensation statutes and MEMIC’s best practices.

• Quality Assurance: Maintain organized and high-quality claim files in accordance with company policies and procedures.

• Managed Care Coordination: Implement Managed Care strategies, coordinate rehabilitation plans, process medical bills, and monitor case progress.

• Legal & Regulatory Compliance: Interact with state and federal boards and commissions to ensure proper reserves and compliance with laws and regulations.

• Ongoing Learning: Stay updated on state laws and workers’ compensation trends through MEMIC-provided training and external certifications like WCP or Claims Law (AEI).

Qualifications

• 3+ years workers' compensation lost time claim handling experience required.

• Strong attention to detail and excellent verbal and written communication skills.

• Proficiency in Microsoft Office Suite (Word and Excel) required and Imageright preferred.

• Self-motivated, flexible, and capable of managing time and priorities effectively in a fast-paced environment.

• Ability to collaborate and build relationships with cross-functional teams.

• Valid driver’s license required.

• Must have required adjuster's licenses in applicable states. (NJ and PA)

Why Join MEMIC?

At MEMIC, we value our employees and offer an exceptional benefits package to support your well-being and professional development, including:

• Health & Wellness: Health, dental, and vision insurance, plus an annual wellness reimbursement.

• Financial Security: 401(k) retirement plan with up to 6% match, profit sharing, and life insurance.

• Paid Time Off: Five weeks of PTO and 11 paid holidays.

• Education & Career Growth: Student loan paydown assistance, tuition reimbursement, and professional development opportunities.

• Work-Life Balance: Paid volunteer day each year.

Join MEMIC Today!

Ready to make an impact in workers’ compensation insurance? As a Claim Specialist, you’ll play a critical role in ensuring injured workers receive the support they need while helping businesses thrive.

MEMIC is committed to fostering a diverse and inclusive workplace. We are an equal opportunity employer, encouraging applicants of all backgrounds and identities to apply.

Apply today and launch your career with MEMIC, where safety and compassion are at the heart of everything we do.

MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law. MEMIC is an equal opportunity employer encouraging diversity in the workplace.

MEMIC's Job Applicant Privacy Notice

#IND2022