Claims Management Specialist (Remote-TX)
Core
Manage workers' compensation claims from injury reporting through closure, serving as the primary liaison between clients, injured employees, insurance carriers, and internal stakeholders.
Role type
Claims Management Specialist
Builds
Efficient claim handling and return-to-work outcomes for client companies and injured employees
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
workers' compensation claims processes, return-to-work programs, claim resolution practices, OSHA regulations, workplace safety, accident prevention programs, bilingual Spanish communication, claim documentation management, loss trend analysis, risk-related information analysis
Preferred skills
Human Resources, Risk Management and Insurance degree, organizational skills, problem-solving, sound judgment
Technologies
None stated
Responsibilities
Coordinate and manage workers' compensation claims from initial injury reporting through resolution and closure; Serve as the primary liaison between client companies, injured employees, insurance carriers, claim adjusters, medical providers, payroll, HR, and internal stakeholders; Educate clients and injured employees on workers' compensation procedures, reporting requirements, return-to-work programs, available resources, and their responsibilities; Provide exceptional customer service and guidance while ensuring all parties understand required protocols, next steps, and claim-related obligations; Coordinate claim documentation, wage reporting, claim-related communications, and return-to-work activities; Monitor claim progress and collaborate with carriers, adjusters, employers, and medical providers to facilitate efficient claim resolution; Review claim status with carriers and adjusters, participate in client claim reviews, and assist with the collection and analysis of claims history, loss trends, and risk-related information; Maintain accurate claim records, documentation, and reporting; Maintain necessary certifications
Seniority
Mid-level, hands-on IC
