Workers Compensation Claims Specialist

Job Summary

Analyzing complex workers compensation claims, the full-time Specialty Operations Specialist will manage high exposure claims involving litigation and rehabilitation while ensuring compliance with company standards and industry best practices in a remote environment.

Key responsibilities

• Investigates and processes complex claims, developing action plans for timely resolution
• Monitors reserve adequacy and ensures accurate benefits due and payment calculations
• Coordinates vendor referrals and communicates with all relevant parties regarding claim status

Required qualifications

• Bachelor's degree from an accredited college or university preferred
• Four years of claims management experience or equivalent combination of education and experience required
• In-depth knowledge of insurance principles, laws, and cost containment techniques
• Professional certification as applicable to line-of-business preferred
• Proficiency in Microsoft Office products and strong analytical skills