Senior Worker's Compensation Claims Professional

SFM Mutual Insurance Companies•Bloomington, MN

3d•Hybrid

About The Position

Are you a seasoned workers’ compensation claims professional who thrives on solving complex cases and making a meaningful impact? At SFM, you’ll manage high-exposure and complex lost-time claims while partnering closely with injured workers, employers, and internal experts to drive the best outcomes. This role is ideal for someone who brings both technical expertise and a collaborative mindset to every claim. Experience with South Dakota claims is highly desirable.

Requirements

4+ years of workers’ compensation lost-time claims experience, with exposure to complex or catastrophic cases.
Experience with Minnesota and South Dakota claims is highly desirable
Strong knowledge of workers’ compensation statutes, medical terminology, and claims best practices.
Proven ability to investigate, negotiate, and resolve claims effectively while managing competing priorities.
Confidence in handling high-stakes conversations with injured workers, employers, attorneys, and internal partners.
Excellent communication skills, with the ability to explain complex information clearly and professionally.
A collaborative, team-first mindset with a willingness to share knowledge and support others.
Strong analytical and problem-solving skills, with sound judgment in decision-making.

Nice To Haves

Bachelor’s degree and/or industry designations (CPCU, ARM) preferred.

Responsibilities

Manage a portfolio of complex workers’ compensation claims, including catastrophic and high-exposure cases, from initial investigation through resolution.
Analyze facts, apply state statutes and case law, and make sound compensability and liability decisions.
Establish and adjust reserves, clearly communicating claim exposure and strategies to employers, reinsurers, and internal stakeholders.
Proactively drive return-to-work and stay-at-work outcomes by collaborating with medical providers, case managers, legal partners, and rehabilitation specialists.
Authorize and manage medical and indemnity benefits within authority, ensuring accuracy and compliance with all regulatory requirements.
Develop and document clear claim strategies, action plans, and settlement analyses to move cases toward resolution.
Serve as a resource and mentor to team members, contributing to strategy discussions, roundtables, and continuous improvement efforts.
Maintain accurate and timely claim data to meet internal standards and state reporting requirements.