Senior Workers Compensation Claim Representative (Workers' Compensation)

Location: Hybrid role in Buffalo, New York, with Albany, New York also listed as a location; United States

Annual base salary: $72,200–$119,000, with eligibility for performance-based cash incentive awards.

Company

hirify.global is a property and casualty insurer focused on serving customers and communities through collaborative, innovation-oriented insurance operations.

What you will do

• Investigate workers' compensation claims, assess coverage and compensability, contact insureds, injured workers, medical providers, and other parties, and determine causal relatedness.
• Manage low-to-high complexity claims, including medical treatment, wage loss, permanent restrictions, vocational rehabilitation, fatalities, reopened claims, and moderate-to-complex litigation.
• Establish and update reserves, evaluate liability and damages, pursue offsets, apportionment, contribution, subrogation, and potential fraud investigations.
• Coordinate medical and indemnity strategies with Medical Case Managers and other medical and legal specialists to support return to work, benefit resolution, and claim closure.
• Prepare statutory letters and filings, negotiate settlements and structured settlements, and manage Medicare Set-Asides and allocations.
• Conduct file reviews, communicate claim status, mentor Claim Professionals, and serve as a technical resource.

Requirements

• High school diploma or equivalent.
• At least 2 years of workers' compensation claim handling experience.
• Advanced analytical, communication, negotiation, case resolution, settlement, valuation, and planning skills.
• Knowledge of insurance contracts, investigations, policy conditions, liability, reserves, damages, and settlement techniques.
• Thorough knowledge of applicable state, federal, regulatory, evidentiary, litigation, discovery, and court proceedings requirements.
• Intermediate medical knowledge covering injuries, disability periods, and required treatment.
• Advanced workers' compensation technical knowledge and ability to work within the jurisdictional parameters of the assigned state.
• Ability to build productive relationships with insureds, collaborate with interdependent teams, and present file resolutions to stakeholders.
• Required insurance license(s) may need to be obtained within three months of starting and maintained with continuing education.

Culture & Benefits

• Full-time hybrid employment with health coverage for eligible employees and family members from the first day.
• Dollar-for-dollar 401(k) matching up to the first 5% of eligible pay, a pension plan funded by hirify.global, and a student-loan savings program.
• At least 20 paid time-off days annually plus nine paid company holidays.
• Wellness, caregiving, mental-health counseling, health coaching, and related support resources.
• Volunteer and charitable giving programs, including matching gifts and volunteer rewards.