Claims Specialist

Posted Yesterday
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Duluth, GA, USA
In-Office
Mid level
Insurance • Marketing Tech
The Role
Handles workers’ compensation claims, primarily medical-only cases, from investigation through resolution. Reviews coverage, statutes, medical records, reserves, and claim facts; determines compensability; coordinates treatment and return-to-work efforts; negotiates settlements; maintains compliant documentation; and oversees external vendors such as nurse case managers and investigators. Provides customer service to injured workers, employers, medical providers, and counsel while managing multiple claims and traveling to off-site locations as needed.
Summary Generated by Built In
Job Summary & Responsibilities

Old Republic Bitco is seeking a Worker’s Compensation Claims Specialist to join our regional office located in Duluth, GA. As a respected specialty insurer with 11 branch offices across 10 states, OR Bitco delivers tailored insurance solutions to complex industries such as construction, forest products, and oil and gas. This position is open to a hybrid work arrangement, blending flexibility with meaningful in person collaboration.


At OR Bitco, our work is guided by core values. We care deeply about our people, partners, and customers. We are committed to excellence and accountability. We deliver on our promises with integrity and precision, and we strive to make a meaningful impact in everything we do. These values drive our mission to protect the people and industries that keep America running.


Join the OR Bitco team and be part of a workplace built on collaboration, open communication, and a positive culture that supports growth and success. If you are passionate about operational excellence and ready to make a measurable impact within a growing, industry-leading organization, OR Bitco offers the platform and challenge you have been looking for.


Position Summary:

This position provides key support in the handling of Workers' Compensation claims, with a primary focus on medical-only claims. Responsibilities include investigating claim details, assessing compensability, coordinating medical treatment, facilitating return-to-work efforts, and ensuring claims are managed and resolved in a timely manner in accordance with company policies and regulatory requirements. Provides a high level of customer service to injured employees, employer representatives, medical providers, and other internal and external business partners.


Primary Responsibilities:

  • Review, analyze, and interpret Workers' Compensation statutes, regulations, medical documentation, and claim facts to determine compensability and resolve claim-related issues.
  • Review and evaluate claim reserves to ensure financial exposure is accurately reflected based on the nature and severity of the claim.
  • Investigate claims by gathering and analyzing relevant information, including employee statements, employer reports, witness accounts, medical records, and other supporting documentation.
  • Coordinate and monitor medical treatment plans and facilitate return-to-work efforts in collaboration with injured employees, employers, medical providers, and claim partners.
  • Maintain timely and accurate claim documentation and reporting in accordance with company standards and regulatory requirements.
  • Provide responsive, professional customer service to injured workers, policyholders, medical providers, and other stakeholders throughout the claims process.
  • Evaluate, negotiate, and resolve claims within assigned authority while ensuring fair and appropriate claim outcomes.
  • Direct and oversee the activities of nurse case managers, medical vendors, investigators, and other third-party service providers as needed.
  • Perform other duties as assigned.

Qualifications:

  • Minimum of 3 years of experience with the following:
    • Coverage Review – interpreting policies, agreements and disclaimers
    • Claims Investigation – Statements, authorizations, retention of qualified experts and counsel
    • Claims Administration – Reports, review reserves, compliance knowledge of laws and procedures
    • Claims Settlement – Preparation of disclaimer letters, releases, and proof of loss statements; participation in legal court proceedings when necessary
  • Knowledge of coverage, negligence principles, investigation and negotiation techniques
  • Ability to obtain and maintain state adjusting licenses, as needed
  • Must be service-oriented, with the ability to provide prompt, efficient, and effective claims and customer service
  • Ability to communicate clearly and effectively with our customers, claimants, opposing counsel, defense counsel, and members of the public
  • Ability to manage and organize workload of multiple tasks simultaneously
  • Excellent judgement, negotiation, and decision making skills
  • Must be able to travel between different off-site locations or overnight in an expeditious manner
  • Experience in handling worker’s compensation claims in one or more of the following states: FL, GA, AL, NC, SC, VA, and PA

Benefits:

  • Competitive salary paired with a comprehensive benefits package
  • Generous paid time off, plus 12 paid holidays annually
  • Comprehensive health coverage, including medical, dental, and vision plans
  • Additional protection through accident, critical illness, and hospital indemnity insurance
  • Company-paid life insurance equal to 2× annual salary
  • Company-paid short-term and long-term disability coverage
  • 401(k) Savings and Profit-Sharing Plan through Old Republic
  • Ongoing education, training, and professional development opportunities
  • Support for industry certifications and insurance designations, including financial assistance
  • Flexible scheduling with a two-hour window for start and end times within a 7.5-hour workday
  • Opportunities to give back through corporate philanthropy and community service initiatives
  • Optional benefits including travel, commuter, and pet insurance
  • Employee wellness support through a dedicated fitness program

 

Skills Required

  • At least 3 years of experience in coverage review, claims investigation, claims administration, and claims settlement
  • Knowledge of coverage, negligence principles, investigation, and negotiation techniques
  • Ability to obtain and maintain state adjusting licenses as needed
  • Experience handling workers’ compensation claims in FL, GA, AL, NC, SC, VA, or PA
  • Strong customer service skills
  • Clear and effective communication with customers, claimants, attorneys, and the public
  • Ability to organize and manage multiple tasks simultaneously
  • Excellent judgment, negotiation, and decision-making skills
  • Ability to travel between off-site locations or stay overnight when necessary
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The Company
HQ: Davenport, IA
359 Employees
Year Founded: 1917

What We Do

At BITCO, we market our products through independent insurance agents and recognize them as vital to the trusting customer relations we build and maintain. Through our network of local service offices, we keep our highly trained people accessible -- supporting our belief that for there is no substitute for personal, local service. BITCO is part of Old Republic General Insurance Group, the largest business segment of Old Republic International (NYSE: ORI), one of America's 50 largest shareholder-owned insurance businesses.

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