Claims Specialist

Nouria • Worcester, MA

10d • Onsite

About The Position

The Workers Compensation Claims Specialist works with a collaborative team of risk, safety, compliance, and legal professionals to administer and manage claims from investigation through resolution and to reduce enterprise risk. Under general direction, the [WC Claims Specialist’s] core responsibilities include timely processing and effective administration of workers' compensation (and other insured) claims; evaluating incident reports for accuracy and completeness and facilitating investigation and information/evidence gathering; evaluating and facilitating return to work programs; related data analysis; coordinating with internal and external parties; and supporting the risk management, legal and safety departments to facilitate risk management.

Requirements

• Proactive, team player and collaborative spirt.
• Ability to handle private, sensitive, confidential information appropriately.
• Working knowledge of medical terminology, body systems and/or impairments and their disabling effects.
• Working knowledge of office procedures and files.
• Strong attention to detail and organizational skills.
• High school diploma or equivalent.
• Strong written and verbal communication skills.
• MS Office skills, esp. Excel, Teams, Word, and PowerPoint.
• Operate office equipment including computers and associated software such as word processing, spreadsheet applications and Workers’ Compensation software programs
• Desire to learn and grow within the organization.
• Ability to learn and work with online claims systems

Nice To Haves

• Some general liability claims administration experience preferred.
• bachelor’s degree and/or relevant work experience preferred.
• Prior OSHA recordkeeping preferred.

Responsibilities

• Review incident reports, investigate assigned claims as needed, and determine compensability.
• Prepare and submit reports and other paperwork to employees, insurers, attorneys, third party claims administrators, OSHA, and other federal and state agencies.
• Develop and facilitate return to work policy.
• Reduce administrative burden on affected employees and front-line managers by liaising administratively on their behalf.
• Assist injured employees in submitting claims and navigating the claims processes.
• Assist Risk Management in administering GL, PLL and other claims as requested.
• Monitor and manage workers compensation claims and oversee claims administrators.
• Maintain OSHA 300 logs.
• Assist in evaluating settlement proposals.
• Analyze claims data and make recommendations to mitigate risk.
• Participate in establishing claim reserves by estimating the cost of each assigned claim; monitor reserves and update amounts as necessary.
• Coordinate medical treatment for injured employees and provide information to treating health care providers.
• Compile, organize, and summarize claims/injury data to identify trends and prepare and present associated analytics.
• Participate in safety committee and other safety and risk management initiatives.
• Assist the Safety and Risk Management Departments in drafting policies, procedures, and other safety/risk management training.

Benefits

• equal opportunity employer
• celebrate diversity
• creating an inclusive environment for all employees

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED