Litigated Claims Specialist

Injured Workers Pharmacy • Andover, MA

15d • $24 - $27

About The Position

Working as part of the Claims Department, the Litigated Claims Specialist applies knowledge of workers' compensation laws, regulations, and jurisdictional requirements to investigate, manage, and resolve disputed claims. The role partners closely with internal teams, attorneys, and insurance adjusters to drive timely reimbursement and support positive claim outcomes. The position works a full-time schedule, Monday to Friday, 9:00 a.m. to 5:30 p.m.

Requirements

• Strong analytical, problem-solving, and organizational skills.
• Proficiency with Microsoft Office applications, including Excel and Word.
• Ability to interpret claim documentation, legal correspondence, and reimbursement-related information.
• Strong written and verbal communication skills.

Nice To Haves

• Three or more years of workers' compensation claims experience, including exposure to litigated claims.
• Experience working with attorneys, adjusters, or other claims stakeholders.
• Knowledge of pharmacy or medical reimbursement processes.

Responsibilities

• Investigate and resolve partial payments and outstanding balances on claims in litigation.
• Secure payment on outstanding invoices through research, follow-up, and coordination with external parties.
• Review and analyze litigated claims to identify issues, opportunities, and appropriate next steps.
• Assess current and ongoing risk related to medication services impacted by active litigation.
• Research claim information, documentation, and legal updates to support claim resolution.
• Communicate and collaborate daily with internal departments to ensure timely claim processing.
• Serve as a point of contact for attorneys, adjusters, and other external stakeholders.
• Obtain and review medical documentation necessary to support collection and reimbursement efforts.
• Analyze claim data and supporting documentation to make informed decisions and recommendations.
• Contribute to the development and improvement of team processes, procedures, and best practices.
• Participate in special projects and perform other duties as assigned.

Benefits

• Monthly engagement events and larger annual celebrations.
• Tuition reimbursement.
• Competitive benefits package.
• Opportunities for career growth and development.
• Positive, inclusive environment where employees feel valued, supported, and empowered.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed