Responsibilities:

We are seeking a highly organized and analytical Workers Compensation Specialist to manage and process claims related to workers’ compensation with a willingness and ability to property damage, and auto incidents. This role involves investigating claims, determining liability, and ensuring timely and fair resolution in accordance with company policies and regulatory requirements. The ideal candidate will have a strong understanding of workers’ compensation insurance practices and a commitment to delivering excellent service to claimants and stakeholders.

• Review and process injury claims filed by employees through claims system workflow.
• Coordinate with medical providers, employers, and legal representatives.
• Ensure compliance with state and federal workers’ compensation laws.
• Monitor return-to-work programs and manage ongoing case files.
• Maintain accurate documentation and update claim management system.
• Identify and escalate potential fraud or complex cases.
• Provide timely updates and resolutions to claimants and internal teams.
• Support continuous improvement initiatives in claims handling processes.

Qualifications:

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• 5 years of experience in insurance claims, preferably in workers’ compensation.
• Knowledge of relevant laws, regulations, and industry standards.
• Strong analytical and decision-making skills.
• Excellent communication and customer service abilities.
• Proficiency in claims management software and Microsoft Office Suite.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Overview:

• Review and process injury claims filed by employees through claims system workflow.
• Coordinate with medical providers, employers, and legal representatives.
• Ensure compliance with state and federal workers’ compensation laws.
• Monitor return-to-work programs and manage ongoing case files.
• Maintain accurate documentation and update claim management system.
• Identify and escalate potential fraud or complex cases.
• Provide timely updates and resolutions to claimants and internal teams.
• Support continuous improvement initiatives in claims handling processes