Claim Specialist I

MEMIC•Portland, ME

7d•$60,000 - $70,000•Hybrid

About The Position

This position is in-person to start then transitions to hybrid. Prior claims handling experience required and one year of workers’ compensation claim handling experience preferred. Are you a natural investigator, problem solver, and relationship builder? Do you thrive in a fast-paced environment where every day presents a new challenge? If so, we invite you to join our team as a Claim Specialist I. In this role, you'll play a critical part in helping injured workers navigate the claims process while partnering with employers, agents, medical providers, and legal professionals to deliver fair, timely, and compassionate claim resolutions. You'll manage a diverse portfolio of workers' compensation claims, balancing analytical thinking, sound judgment, and exceptional customer service.

Requirements

Prior claims handling experience required
One year of workers’ compensation claim handling experience preferred
Computer skills, Word, Excel and Image Right preferred.
Must have valid driver’s license.
Strong attention to detail and strong communication skills both verbal and written.
Adaptable/flexible and self-directed with the ability to manage time and other resources wisely.
Must have the ability to work effectively with other organizational team members.

Nice To Haves

One year of workers’ compensation claim handling experience
Computer skills, Word, Excel and Image Right

Responsibilities

Investigate and Evaluate Workers' Compensation Claims: Gather facts, analyze coverage and compensability, determine liability, and assess claim exposure. Conduct interviews and maintain communication with injured workers, employers, witnesses, attorneys, brokers, agents, and other stakeholders.
Manage Claims from Start to Finish: Administer timely and accurate indemnity and medical benefits. Establish appropriate reserves and make informed settlement decisions within authority levels. Negotiate claim resolutions and pursue cost-effective outcomes.
Partner with Legal and Medical Professionals: Collaborate with defense counsel on litigated claims. Attend mediations, arbitrations, hearings, and settlement conferences when needed. Implement managed care and rehabilitation strategies to support recovery and claim resolution.
Build Strong Relationships: Work directly with insureds and injured employees to provide guidance, education, and support. Conduct on-site visits, presentations, and claim reviews to strengthen customer partnerships.
Maintain Excellence and Compliance: Ensure claim files meet quality standards, regulatory requirements, and company best practices. Stay current on workers' compensation laws, regulations, and industry trends. Utilize technology and claims systems to effectively manage workload and documentation.