MEMIC · 6 hours ago
Claim Specialist
Portland, Maine
Full-time
Onsite
Mid Level
3+ years expMEMIC is a company focused on workers' compensation and claims management. The Claim Specialist III role involves investigating, evaluating, negotiating, and resolving lost time claims while providing training for less experienced representatives.
Financial ServicesInsurance
Responsibilities
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
Administers the delivery of timely, appropriate and accurate indemnity and medical benefits
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
Works closely with insureds and employees making visitations and presentations as needed to facilitate partnership approach to claims handling
Maintains quality claim files in accordance with appropriate best practices, and other company procedures
Implements Managed Care strategies, coordinate rehabilitation or medical management, process bills, review all mail through Image Right, and monitor progress as appropriate
Interacts with State and Federal Boards and Commissions, while establishing and maintaining proper reserves, as appropriate
Serves as a mentor and helps prepare/train the less experienced Claim Department representatives
Keeps up-to-date on State laws and Company procedures relating to various claims; educates injured worker and/or insured on same
Prepares and presents files for Agent/Broker Reviews and Insured File Review
Understands medical terminology and standard medical procedures as they pertain to worker’s compensation, U.S. Longshoreman’s and Jones Act claims
Participates in in-house and outside training programs to keep up-to-date on relevant issues/topics
Maintains a working knowledge of all computer systems currently in use
Continues education in claims through Associate in Claims or Claims Law (AEI) courses
Qualification
Required
Three years of workers' compensation lost time claim handling experience required
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
Preferred
Bachelor's degree
Computer skills, Word, Excel and Image Right
Benefits
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 5%, plus profit sharing & discretionary contributions (subject to vesting)
5 weeks of Paid Time Off (PTO)
11 paid holidays
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
On-site fitness center (Maine only) or fitness reimbursement
Subsidized parking
Sit-Stand desks & daily stretch breaks
Company
MEMIC
MEMIC is Maine's workers' compensation insurer, through Maine Employers Mutual Insurance Company.
201-500 employees
Funding
Current Stage
Late StageTotal Funding
$70M2025-12-10Debt Financing· $70M
2021-04-28Series D
Leadership Team
Michael Bourque
President and CEO
Catherine Lamson, SPHR, SHRM-SCP, WCP®
Senior Vice President, Chief Administrative Officer
Recent News
2025-11-11
2025-09-13
Company data provided by crunchbase