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Workers Compensation Claims Specialist Jobs

Workers Compensation Claims Advisor - Overland Park, Ks Or Remote
By CRH Americas Corporate At , Atlanta, 30338
Provide WC claims’ management education and WC regulatory updates to local business units.
Bachelor’s degree in Risk Management, Finance or Nursing background preferred
Ability to effectively work and collaborate with people with a wide range of skills, experience, cultures, and capabilities
Other duties as directed by management
Minimum seven (7) years of experience managing WC claims
WC technical knowledge and WC case law in multiple jurisdictions from Ohio to California
Workers' Compensation Claims Facilitator
By State of Hawaii At , Island Of Hawai‘i $4,690 - $5,493 a month
C (Download PDF reader)lick here to view Minimum Qualification Specification (Download PDF reader)
Click here to view Minimum Qualification Specification (Download PDF reader)
o qualify, you must meet all of the following requirements:
Professional Trainee II: SR-18, Salary $4,339 per month
Professional Trainee I: SR-16, Salary $4,011 per month
Consideration may be given to lower levels:
Workers Compensation Claims Advisor - West - Remote
By CRH Americas Corporate At , Phoenix $85,000 - $100,000 a year
Provide WC claims’ management education and WC regulatory updates to local business units.
Bachelor’s degree in Risk Management, Finance or Nursing background preferred
Ability to effectively work and collaborate with people with a wide range of skills, experience, cultures, and capabilities
Other duties as directed by management
Minimum seven (7) years of experience managing WC claims
WC technical knowledge and WC case law in multiple jurisdictions from Ohio to California
Senior Workers Compensation Claims Specialist I/Ii- Eberle Vivian
By Liberty Mutual At , Remote $72,300 - $127,700 a year
Leadership ability and demonstrated time management skills to delegate work appropriately and organize resources effectively.
Manages an inventory of workers compensation claims to evaluate compensability/liability.
Excellent interpersonal skills to communicate and negotiate with customers and conduct investigations required.
Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
Plans and conducts investigations of claims to confirm coverage and compensability.
Performs other duties as assigned.
Workers' Compensation Specialist Jobs
By Lincoln Electric At , Cleveland, 44117
Builds a rapport with employees and management to ensure interdepartmental collaboration on claim-related issues and coordination of Return to Work.
Knowledge of Microsoft Office with Excel experience
Reviews, investigates and makes decisions regarding compensability and appropriateness of claims through discussion with employees, managers and safety team
Bachelor’s degree with experience in Self Insurance OR 6 years of Ohio BWC self-insurance experience in lieu of a degree
Excellent verbal and written communication skills
Processes and documents workers’ compensation claims, ensuring compliance with relevant policies.
Workers' Compensation Claims Representative - Med Only
By Berkley At , Rocky Hill, 06067
Manage existing workloads effectively to achieve quality and quantity production goals while providing superior customer service.
Control file-related expenses through efficient utilization and monitoring of "outside" vendors.
Inform other departments of positive/negative conditions noted during investigations which may impact company results.
(Remote) Claims Team Lead - Workers Compensation
By Sedgwick At , Chicago
Education & Licensing: 5-7 years of claims management experience or equivalent combination of education and experience required.
Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
Compiles reviews and analyzes management reports and takes appropriate action.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one
Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
Performs quality review on claims in compliance with audit requirements, service contract requirements, and quality standards.
Claims Technician - Workers' Compensation
By Sierra Pacific Industries At , Anderson, 96007 $17 - $25 an hour
Process payment of medical bills and invoices, meeting all statutory timeliness requirements
Minimum of one year of progressive office administration experience
Knowledge of workers’ compensation terminology preferred
Communicate with injured workers and service providers to facilitate claims administration
Provide injured workers with information about the workers’ compensation process
Handle multiple priorities simultaneously and effectively prioritize tasks to meet deadlines
Workers Compensation Subrogation Specialist
By EXL Services At , Remote
Issue notices in accordance client requirements and state specific regulations
1-3 years’ experience in General Liability, Personal Injury, Products Liability, or Workers’ Compensation Claims
Bachelor’s degree or equivalent work experience
Strong written and verbal skills
As the role grows, ability to learn quickly and take on new challenges and responsibilities
Review and identify claims with subrogation potential
(Remote) Claims Representative - Workers Compensation
By Sedgwick At , Troy
Education & Licensing: 3+years of claims management experience or equivalent combination of education and experience required.
Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
Professional certification as applicable to line of business preferred.
Claims Representative - Workers Compensation Remote
By Sedgwick At ,
Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
Excellent oral and written communication, including presentation skills
Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
Administers subrogation of claims and negotiates settlements.
Communicates claim action with claimant and client.
Ensures claim files are properly documented and claims coding is correct.
Claims Manager, Workers Compensation
By Nationwide At , Remote
Education: Undergraduate studies in business administration or related field preferred and/or relevant Workers’ Compensation experience.
Other criteria, including leadership skills, competencies and experiences may take precedence.
Registered Nurse (RN) licensure required; Successful completion of required claims certification schools/courses. State licensing where required.
Three or more years of clinical experience required, medical coding or medical billing preferred.
Strong data analysis skills to determine medical bill rule design.
Delivers a positive customer service experience to all internal, external, current and prospective Nationwide customers.
Workers Compensation Claims Assistant I
By Intercare Holdings Insurance Services At , $18.27 - $22.11 an hour
Calculates TTD, Wage Loss, VRMA and PD benefits
Issues compensation payments on diary schedule
Doctor status calls and Employee/Employer contact calls
Employer contact calls to confirm light duty/modifies work
Works closely with Claims Specialist to complete clerical assignments
Prepares litigation documents such as C&R, Stipulations, Answers, etc
Claims Representative - Workers Compensation
By Sedgwick At ,
Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
Excellent oral and written communication, including presentation skills
Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
Administers subrogation of claims and negotiates settlements.
Communicates claim action with claimant and client.
Ensures claim files are properly documented and claims coding is correct.
Claims Associate - Workers Compensation | Roseville, Ca
By Sedgwick At , Roseville
Education & Licensing: 2+ years of claims management experience or equivalent combination of education and experience required.
Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
Professional certification as applicable to line of business preferred.
Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
Workers Compensation Claims Advisor
By FedEx Services At , Memphis $6,047 - $10,768 a month
Bachelor's Degree/or equivalent in Risk Management, Business, Finance, or related field.
Verbal and written communication skills necessary to communicate with all levels of management and third-party providers
Apply aggressive litigation cost management strategy on individual WC claim files
Adhere to quality management and compliance protocols
Ensure WC vendors are complying with service instructions and guidelines and escalate specific issues to Manager
Confirm initial and ongoing TPA reporting of WC claims requiring excess notification, and escalate claims meeting defined criteria to Manager
Workers Compensation Tpa Claims Assistant
By EMC Insurance At , Remote
Ability to attain all applicable state licenses within 30 days of hire and maintain appropriate continued education requirements
Notifies the Claim Manager/Supervisor of claims which require assignment to higher level Claims team members
Three years of claims support experience or related experience
Basic knowledge of insurance and claims processing
Strong knowledge of insurance and claims terminology
Good knowledge of computers, software, and applications
Workers’ Compensation & Safety Specialist
By NEFCO At United States
Excellent time management skills with a proven ability to meet deadlines.
Provides local management with notices of absence and notices of return to work.
Excellent verbal and written communication skills.
Excellent interpersonal and customer service skills.
Excellent organizational skills and attention to detail.
Strong analytical and problem-solving skills.
Workers' Compensation | Safety Compliance Specialist
By Airgas At The Woodlands, TX, United States
Compile the region’s safety-related Key Performance Indicator (KPI) data for corporate and region management review
Perform accident / incident investigations to determine immediate cause as well as root cause; recommend changes to correct and prevent reoccurrence.
Process the region’s Certificate of Insurance (COI) requests from customers, contractors and other stakeholders
Assist in the formulation of general safety policies and procedures in compliance with local, state, and federal rules and regulations.
Must possess valid state driver's license, clean driving record, and appropriate level of auto insurance coverage.
Your differences enhance our performance
Workers' Compensation Premium Audit Specialist | Remote
By King's Insurance Staffing LLC At United States
4 - 8+ years of Workers’ Compensation Premium Audit experience
Thorough knowledge of Microsoft Excel including effective tools and methods for importing, analyzing, combining, and manipulating large worksheets with extensive data
Excellent conflict avoidance and resolution skills, with the ability to deescalate situations involving agitated clients, using effective verbal communication.
Flex schedule and ability to work remotely
Make referrals to underwriting on pertinent information found during the review process.
Review Workers’ Compensation policy audit and bill the final policy premium and monthly interim audits.

Are you looking for a challenging and rewarding role in the Workers Compensation industry? We are looking for an experienced Claims Specialist to join our team and help us provide the best service to our clients. You will be responsible for managing and resolving complex claims, ensuring compliance with applicable laws, and providing excellent customer service. If you have a passion for helping people and a drive to succeed, this could be the perfect job for you!

Overview A Workers Compensation Claims Specialist is responsible for managing workers compensation claims and ensuring that injured workers receive the necessary medical care and financial compensation. They must be knowledgeable about the laws and regulations governing workers compensation and be able to interpret them in order to make sound decisions. Detailed Job Description A Workers Compensation Claims Specialist is responsible for managing workers compensation claims. This includes investigating claims, gathering evidence, and making decisions regarding the validity of the claim. They must be knowledgeable about the laws and regulations governing workers compensation and be able to interpret them in order to make sound decisions. They must also be able to communicate effectively with injured workers, employers, and insurance companies. Job Skill Requirements
• Knowledge of workers compensation laws and regulations
• Ability to interpret and apply laws and regulations
• Excellent communication and interpersonal skills
• Ability to investigate and analyze claims
• Ability to make sound decisions
• Ability to work independently and as part of a team
• Ability to handle multiple tasks simultaneously
• Proficiency in computer software programs
Job Qualifications
• Bachelor’s degree in business, law, or a related field
• Previous experience in workers compensation claims
• Certification in workers compensation
Job Knowledge
• Knowledge of workers compensation laws and regulations
• Knowledge of medical terminology
• Knowledge of insurance policies and procedures
• Knowledge of legal terminology
Job Experience
• Previous experience in workers compensation claims
• Previous experience in insurance or legal field
Job Responsibilities
• Investigate workers compensation claims
• Gather evidence to support claims
• Analyze claims and make decisions regarding validity
• Communicate with injured workers, employers, and insurance companies
• Ensure that injured workers receive necessary medical care and financial compensation
• Maintain accurate records of claims
• Monitor claims to ensure timely resolution
• Prepare reports and documents related to claims
• Stay up to date on changes in workers compensation laws and regulations