Claims Specialist IV
Portland, OR - USA
Job Summary
- Own the full claim lifecycle: Investigate evaluate negotiate and resolve lost time workers compensation claims within designated settlement and reserving authority
- Analyze complex exposures: Assess compensability medical legal and indemnity factors while proactively managing risk and claim cost drivers
- Navigate jurisdictional requirements: Ensure compliance with state-specific WC laws litigation processes and regulatory guidelines
- Strategically manage claims: Develop and execute resolution strategies including collaboration with defense counsel medical providers and vendors
- Exercise advanced judgment: Handle a high-exposure complex caseload with a high degree of autonomy and limited supervision
- Develop others: Design and deliver training sessions research materials and technical guidance for less experienced adjusters
- Serve as a subject matter expert: Provide leadership in best practices reserving settlement strategy and claim handling excellence
- Complex high-impact caseload: Manage litigated and non-litigated lost time claims requiring deep technical expertise
- Expanded authority: Settlement and reserving authority aligned with your experience and demonstrated capabilities
- Influential role: Shape claim outcomes and elevate team performance through mentorship and knowledge sharing
- Cross-functional exposure: Regular collaboration with legal medical management underwriting and risk partners
- Proven experience managing lost time claims with increasing complexity - 4 years of WC lost time claim handling required
- Strong negotiation and analytical skills with a focus on resolution
- Ability to work independently while maintaining high-quality outcomes
- Passion for mentoring training and knowledge sharing
- Demonstrated ability to handle confidential high-impact situations with professionalism
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 veterans status sexual orientation or any other characteristic protected by law. Additionally we are committed to providing an inclusive and accessible recruitment experience for all candidates. If you need a reasonable accommodation during the interview process please contact us at
To ensure an equitable and authentic interview process candidates should not use AI or chatbot tools during the live interview or phone screen. We welcome any preparation you choose to do beforehand but all responses shared during the interview must be your own.
Note: MEMIC does not offer Stem-OPT EAD Extension for this role.
Check out our benefit offerings here! Targeted salary range:
Required Experience:
IC
About Company
The MEMIC Group provides workers' compensation insurance to employers with an emphasis on workplace safety.