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 workers, insurance providers, claim adjusters, healthcare professionals, payroll, HR, and internal teams.

• Inform clients and injured employees about workers' compensation processes, reporting requirements, return-to-work initiatives, available resources, and responsibilities during the claims journey.

• Deliver customer service and support while ensuring that all parties comprehend necessary protocols, subsequent steps, and obligations related to the claims.

• Organize claim documentation, wage reports, communications related to claims, and return-to-work activities.

• Track claim progress and collaborate with carriers, adjusters, employers, and healthcare providers to ensure swift claim resolution.

• Evaluate claim statuses with carriers and adjusters and engage in client claim assessments.

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

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

• Execute additional duties as assigned.

⛳️ Requirements

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

• At least four (4) years of experience in claims management or a related area is mandatory.

• Familiarity with workers' compensation claims processes, return-to-work programs, and claims resolution methods is essential.

• Knowledge of OSHA regulations, workplace safety standards, and accident prevention strategies is preferred.

• Bilingual proficiency in Spanish is required.

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

• Ability to analyze data, resolve issues, and demonstrate sound judgment.

• Must possess clear and concise written communication skills.

• Strong customer service and relationship management abilities to effectively engage with clients, injured workers, carriers, and internal stakeholders.

• Capability to sit and stand for extended periods while performing sedentary tasks.

• Maintain necessary certifications.

• Pre-employment drug screening is required.

• Must be a non-tobacco user, as permitted by law.

🏝️ Benefits

• Competitive overall compensation package.

• Work/Life balance.

• Employee engagement initiatives and recognition awards.

• Years of Service awards.

• Opportunities for career advancement and professional growth.

• Leadership Academy and Mentor Program.

• Continuing education and career certification opportunities.

• A variety of healthcare coverage options.

• Traditional and Roth 401(k) retirement plans.

• Attractive Wellness Program.