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MEMIC

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Claim Specialist III

This position is no longer accepting applications(closed Aug 18, 2026).

CANDIDATES MUST HAVE GA, VA, TN CLAIMS EXPERIENCE

The Claim Specialist III investigates, evaluates, negotiates, and resolves lost time claims within settlement and reserving authority up to stated maximum. (Supervisor will determine actual individual authority up to the stated maximum). Based on experience and proven ability, an expanded and more difficult caseload will be expected, requiring a lesser degree of supervision.


Principal Duties and Responsibilities
1. Communicates with insureds, injured workers, agents, brokers, witnesses, attorneys, loss prevention, and underwriters to obtain and relate necessary information to determine coverage/compensability, facts of loss, and degree of liability/exposure. Maintains contact throughout the life of the file as needed.
2. Administers the delivery of timely, appropriate and accurate indemnity and medical benefits.
3. Evaluates claim exposure, negotiate and resolve claims. Works closely with defense counsel on litigated cases and attend mediation, arbitration, and hearings, as necessary. Develops litigation plan with defense counsel and tracks adherence to plan in order to control legal expenses and assure effective resolution.
4. Works closely with insureds and employees making visitations and presentations as needed to facilitate partnership approach to claims handling.
5. Maintains quality claim files in accordance with appropriate best practices, and other company procedures.
6. Implements Managed Care strategies, coordinate rehabilitation or medical management, process bills, review all mail through Image Right, and monitor progress as appropriate.
7. Interacts with State and Federal Boards and Commissions, while establishing and maintaining proper reserves, as appropriate.
8. Serves as a mentor and helps prepare/train the less experienced Claim Department representatives.
9. Keeps up-to-date on State laws and Company procedures relating to various claims; educates injured worker and/or insured on same.
10. Prepares and presents files for Agent/Broker Reviews and Insured File Review.
11. Understands medical terminology and standard medical procedures as they pertain to worker’s compensation, U.S. Longshoreman’s and Jones Act claims.
12. Participates in in-house and outside training programs to keep up-to-date on relevant issues/topics.
13. Maintains a working knowledge of all computer systems currently in use.
14. Travels throughout States as required to handle claims inventory assigned.
15. Continues education in claims through Associate in Claims or Claims Law (AEI) courses.


Minimum Knowledge, Skills and Abilities
1. Three years of workers’ compensation lost time and medical only claim handling experience preferred.
2. Bachelor’s degree preferred.
3. Computer skills, Word, Excel and Image Right preferred.
4. Must have a valid driver’s license.
5. Strong attention to detail and strong communication skills both verbal and written.
6. Adaptable/flexible and self-directed with the ability to manage time, multiple priorities and other resources wisely.
7. Must have the ability to work effectively with other organizational team members.

Our comprehensive benefits package includes all traditional offerings such as:

  • Health Insurance options, Dental Insurance options and Vision Insurance
  • Employee Life Insurance/AD&D and Dependent Life Insurance options
  • Short-term & Long-term Disability
  • Health Savings Account with potential employer match
  • Flexible Medical and Dependent Care Account
  • Accident Insurance
  • Critical Illness Insurance
  • Employee Assistance Program
  • Legal/Identify Theft Insurance options
  • Long Term Care Insurance
  • Pet Insurance
  • 401 (k) Retirement Plan with match up to 6%, plus annual bonus based on individual & company performance.
  • 5 weeks of Paid Time Off (PTO)
  • 11 paid holidays

We also offer other benefits to help foster a healthy, balance lifestyle such as:

  • Flextime schedules
  • Paid Parental Leave
  • Student loan paydown and refinancing assistance
  • Educational assistance for job related courses, seminars, certifications or degrees
  • One paid day every year to volunteer for your non-profit of choice
  • Sit-Stand desks & daily stretch breaks

MEMIC is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, age, disability, genetics, gender identity, veteran's status, sexual orientation, or any other characteristic protected by law.

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What this application asks

greenhouse

First Name, Last Name, Email, Phone, Resume/CV, Cover Letter, Location

  • What is the highest level of education you have completed? choose one
  • If you are under 18 and it is required, can you furnish a work permit? choose one
  • Are you legally eligible for employment in this country? choose one
  • Will you now or in the future require sponsorship? choose one
  • Will you relocate if the job requires it? choose one
  • Will you travel if the job requires it? choose one
  • Will you work overtime if required? choose one
  • Are you able to perform the "essential functions" of the job for which you are applying (with or without reasonable accommodation)? choose one
  • Please explain any terminations or gaps in experience. If not applicable, please put N/A. written answer
  • Please list the name, title, telephone number and email of 3 business references. Please indicate their relationship to you. Supervisors preferred. written answer
  • I hereby certify that the information contained in the employment application I submit to Maine Employers’ Mutual Insurance Company, hereinafter referred to as (“MEMIC”) or (“the Company”) is true and complete to the best of my knowledge. I understand that material omissions or falsification of this application may result in my disqualification from consideration for employment or dismissal from employment. I understand that my employment is subject to a satisfactory check of references. I authorize MEMIC and/or its designees the right to investigate the information given and to secure additional information, if necessary. I authorize my previous employers, educational institutions and all other individuals and organizations listed in this application form to provide information about my employment, work habits and character. I agree that MEMIC, and/or its designees and my previous employers, educational institutions and all other individuals and organizations listed in this application form will not be held liable in any respect if an employment offer is not made, is withdrawn, or my employment is terminated because of furnishing necessary information incident to the employment process. I understand that MEMIC is in no way obligated to provide employment and I am in no way obligated to accept employment, if offered. This application does not bind either party, and the statements contained herein do not constitute and should not be interpreted to constitute any sort of contract of employment for a specific period of time. I understand this application for employment is valid for 30 days only. Consideration for employment after 30 days requires a new application. I understand that upon offer and acceptance of a position with MEMIC, I will be required to provide documentation establishing my identity and eligibility to be legally employed in the United States. I understand that employment at MEMIC is employment at will. Employment may be terminated with or without cause at any time by me or by the Company. Terms and conditions of employment with MEMIC may be modified at the sole discretion of the Company with or without cause and with or without notice, except as may be required by law. I also understand that other than the President of the Company, no one has the authority to make any agreement for employment other than for employment at will or to make any agreement limiting the Company’s discretion to modify terms and conditions of employment. MEMIC is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person’s race, national origin, color, religion, age, gender, sexual orientation, gender identity or expression, disability, genetic information, military and veteran status, or any other protected status under applicable federal, state or local law. If you agree to the above, please type your first and last name and today's date.
  • Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way, restrict your ability to work for our company? If yes, please explain. written answer
  • Have you ever been employed here before? If yes, give dates. written answer
  • Have you submitted an application here before? If yes, please give date(s) and position(s). written answer
  • What is your desired annual salary or hourly rate of pay? written answer
  • What is your mailing address? written answer

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