Claims Specialist Jobs

About The Position

Requirements

• At least 3 years of workers’ compensation claims experience; exposure to litigated claims is preferred.
• 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

• Exposure to litigated workers’ compensation 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.
• Research, follow up, and coordinate with external parties to secure payment on outstanding invoices.
• Review and analyze litigated claims to identify issues, opportunities, and appropriate next steps.
• Assess current and ongoing risk related to medication services affected by active litigation.
• Research claim information, documentation, and legal updates to support claim resolution.
• Communicate and collaborate with internal departments to support timely claim processing.
• Serve as a point of contact for attorneys, adjusters, and other external stakeholders.
• Obtain and review medical documentation 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

• Tuition reimbursement.
• Competitive benefits package.
• Competitive salary, generous benefits, and opportunities for growth and development.
• Monthly engagement events and larger annual celebrations, including a tent party, summer BBQ, and Family Fun Day.
• Internal-first job posting philosophy to support career growth.
• Positive, inclusive environment where employees feel valued, supported, and empowered.