The Senior Claims Associate role provides foundational support to the Claims team by managing timely and accurate intake, documentation, and administrative processing of workers’ compensation claims. This position plays a key role in maintaining service-level commitments, strengthening client relationships, and ensuring compliance with regulatory and carrier reporting standards.
The role is non-adjusting and focuses on operational coordination, data accuracy, and service excellence. It serves as an entry point into the claims career path within Risk Management.
Roles and Responsibilities
- Assist in managing workers’ compensation claims from initial report through closure for designated clients.
- Partner with the appointed TPA to ensure compliance with service agreements, including:
- Reviewing basic claim details and supporting documentation.
- Monitoring reserves and ensuring adherence to Standard Service Instructions (SSIs).
- Provide clear status updates and route escalations when higher-level intervention is required.
- Support return-to-work follow-up and ensure client expectations are met throughout the claim lifecycle.
- Monitor critical claim-related deadlines, including wage filings, state form submissions,
and medical updates.
- Assist the Claims Manager in preparing materials for claim reviews, carrier discussions, internal presentations, and departmental reporting.
- Identify and provide solutions for process gaps.
- Uphold privacy, confidentiality, and data governance standards.
- Assist in preparing materials for claim reviews, carrier discussions, internal presentations, and departmental reporting.
- Contribute to internal reporting, including loss runs, data validation, and performance metrics.
- Run recurring and ad hoc reports to validate data and identify discrepancies.
Required Qualifications
- At least 4-5 years of workers’ compensation claims experience
- At least 2 years of experience with master carriers and monopolistic state funds.
- Familiarity with workers’ compensation underwriting, claims, and loss control.
Required Skill Sets
- Working knowledge of workers’ compensation laws and state-specific requirements.
- Robust organizational and analytical skills with attention to detail.
- Effective communicator with strong interpersonal and customer service skills.
- Ability to manage multiple claims and deadlines in a fast-paced environment.
- Proficiency with claims management systems and Microsoft Office Suite.
📌 Senior Claims Associate (India)
🏢 Insure Pro 2.0
📍 India
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