Claims Specialist II, Workers Compensation

Location: United States - Remote; position may be filled within any of the lower 48 U.S. states. The role may require travel to catastrophe sites, customer visits, and extended or non-standard hours.

Salary: $69,500–$129,000 annual national range; expected starting range of $69,500–$103,500.

Company

hirify.global is a Fortune 100 insurance company providing property and casualty coverage and customer-focused claims services.

What you will do

• Investigate and manage medical and loss-of-time workers’ compensation claims across multiple states.
• Determine compensability, entitled benefits, average weekly wages, benefit rates, exposures, and case reserves under applicable state statutes.
• Coordinate medical interventions, independent medical examinations, rehabilitation, utilization review, and return-to-work initiatives.
• Negotiate settlements, manage litigated claims and legal expenses, and pursue third-party recoveries and applicable deductibles.
• Complete statutory notices, electronic reporting, Medicare reporting, severe incident reports, and reinsurance documentation.
• Communicate with policyholders, injured workers, medical providers, attorneys, agents, and internal claims specialists while delivering fair and timely resolutions.

Requirements

• Three to five years of prior workers’ compensation claims experience.
• Advanced knowledge of insurance theory, insurance contracts, medical terminology, workers’ compensation, claims practices, and legal aspects of court procedures.
• Strong investigation, analytical, organizational, written, verbal communication, negotiation, and conflict-resolution skills.
• Ability to manage claims with little to no direction, make decisions within delegated authority, and prioritize complex workloads.
• State licensing where required and successful completion of applicable claims certification training or classes.
• Ability to work remotely from the lower 48 U.S. states and travel when required, including to catastrophe sites.

Nice to have

• Undergraduate studies in business administration or a related field.
• Experience with claims systems, Medicare Set-Asides, structured settlements, SIU, subrogation, or litigation management.
• Leadership experience training, coaching, or providing feedback to less experienced associates.

Culture & Benefits

• Full-time staff employment with an inclusive, equal-opportunity workplace.
• Medical, dental, and vision insurance, life insurance, and short- and long-term disability coverage.
• Paid time off, nine paid holidays, Lifetime paid time off, and Unity Day paid time off.
• 401(k) with company match and a company-paid pension plan.
• Business-casual work environment with remote work and potential catastrophe-response travel.

Hiring process

• Credit and/or background checks are required as part of the selection process.
• Applications are anticipated to be accepted until October 1, 2026, subject to early closure.