Claims Management Specialist

This is a fully remote position, open to applicants in Texas.

📋 Description

• Oversee and manage workers' compensation claims from the initial reporting of injuries to their resolution and closure.

• Act as the main point of contact between client companies, injured employees, insurance carriers, claim adjusters, medical providers, payroll, HR, and internal stakeholders.

• Inform clients and injured employees about workers' compensation procedures, reporting requirements, return-to-work programs, available resources, and their responsibilities.

• Deliver customer service and guidance on required protocols, forthcoming actions, and obligations related to claims.

• Coordinate documentation for claims, wage reporting, communications related to claims, and activities associated with return-to-work.

• Track claim progress and work collaboratively with carriers, adjusters, employers, and medical providers to ensure efficient claim resolution.

• Review claim status with carriers and adjusters.

• Engage in client claim reviews.

• Assist in gathering and analyzing claims history, loss trends, and risk-related data.

• Keep accurate records of claims, documentation, and reporting.

• Carry out additional tasks as assigned.

⛳️ Requirements

• A Bachelor’s degree in Human Resources, Risk Management and Insurance, or a related field from an accredited four-year college or university is preferred.

• At least four (4) years of experience in claims management or a similar field is required.

• Familiarity with workers' compensation claims processes, return-to-work programs, and practices related to claim resolution.

• Preferred knowledge of OSHA regulations, workplace safety practices, and accident prevention programs.

• Bilingual proficiency in Spanish is required.

• Strong organizational skills with the capacity to handle multiple priorities, adhere to deadlines, and maintain attention to detail.

• Capability to analyze information, resolve problems, and exercise sound judgment.

• Ability to communicate clearly and concisely in writing.

• Exceptional customer service and relationship management skills.

• Capacity to sit and stand for extended periods while performing sedentary activities.

• Maintain necessary certifications.

• Must successfully pass pre-employment drug testing.

• Must be a non-tobacco user, in accordance with applicable laws.

🏝️ Benefits

• Competitive overall compensation package.

• Work/Life balance.

• Employee engagement activities and recognition awards.

• Years of Service awards.

• Opportunities for career enhancement and growth.

• Leadership Academy and Mentor Program.

• Continuing education and career certifications.

• A variety of healthcare coverage options.

• Traditional and Roth 401(k) retirement plans.

• Attractive Wellness Program.