Workers' Compensation Claims Specialist III - Southeast

Do you desire to lead and share knowledge with other claims specialists on the team? Have you ever worked for a company whose motto is “Work hard, play hard, and love who you do it with”; who’s passionate about challenging you to think differently; and who cares about YOU the employee?

Creative Risk Solutions is a progressive, fun and fast-paced Third-Party Claims Administrator. At Creative Risk Solutions, our employees play to their strengths and contribute to who we are and want to be.  Are you interested in joining our CRS team as a Workers’ Compensation Claims Specialist III read on!  The person in this position will service self-insured accounts and will telecommute for this role. Qualified candidates will have jurisdictional experience in one or more of the following states: VA, NC, AL, TN, SC, GA, LA.

Duties:

  • Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
  • Investigates, evaluates, and resolves lost time workers’ compensation claims, including litigated claims.
  • Mediates situations as they arise between the insured and the insurance company, to include researching coverage issues.
  • Enters and maintains accurate information on a computer system during the claim process, to include final settlement information.
  • Generates checks for indemnity and medical payments daily.
  • Compiles and interprets workers’ compensation reports on designated accounts, as requested.
  • Participates in claim reviews when requested by agency partners or insured’s.  These could be in person or by phone.    
  • Ability to adjudicate lost time claims in multiple jurisdictions.
  • Develops and monitors consistency in procedural matters of claims handling process within CRS.
  • Willingness to become licensed if required in jurisdiction where claims are handled.

And, let’s not forget the qualifications for the job:

  • Minimum of five year’s claim experience with strong background in workers’ compensation claim handling.
  • A high school diploma or GED equivalent required, college degree preferred.
  • Jurisdictional expertise and required licensing as needed in one or more of the following states: VA, NC, AL, TN, SC, GA, LA.
  • Knowledge of workers’ compensation insurance coverage and the ability to apply knowledge in the performance of the job duties.
  • Skillful knowledge of claims processing procedures.
  • Ability to work with persons under adverse or highly emotional conditions.
  • Knowledge of organizational methods and the ability to manage multiple tasks/duties simultaneously. 
  • Willingness to pursue industry-related education.
  • Ability to work core business hours Monday – Friday and willingness to work extended hours, as necessary.

If you’re ready for a new and exciting opportunity to work for an amazing company and you think you have what it takes to be a Workers’ Compensation Claims Specialist for Creative Risk Solutions, apply today!


EOE

Pre-offer background check required.


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