Workers' Compensation Claims Specialist III - Midwest

Do you have a minimum of 5 years claim handling experience? Do you provide excellent customer service and enjoy building lasting relationships with clients? The position will service a variety of accounts and the option of flexible work arrangements are available for this role. Qualified candidates will have jurisdictional experience in one or more of the following states: IA, IL, IN, and NE.

Responsibilities:

  • 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 and attending Risk Control Workshops when requested by agency partners or insureds. 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.

Knowledge, Skills, and Abilities:

  • Jurisdictional expertise and required licensing as needed in the following states: IA, IL, IN, and NE. 
  • Knowledge of Workers’ Compensation insurance coverage and the ability to apply that 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.
  • Ability to work daily and extended hours, as necessary.
  • Ability to maintain confidentiality.
  • Ability to act in a professional and courteous manner.
  • Ability to learn various software programs.
  • Must be knowledgeable of and comply with HMA's Client Privacy Policy, HIPAA regulations and E&O procedures and policies.

Qualifications:

  • Education: High School education with college preferred.
  • Experience: Minimum of five years claims experience with strong background in Workers’ Compensation claims handling.

In addition to core benefits like health, dental and vision, also enjoy benefits such as:

  • Responsible Time Off
  • Continuing Education
  • Fitness Reimbursement
  • Parental Leave and New Parent Benefits
  • 401k Profit Sharing
  • Flexible work arrangements

 

EOE

Pre-offer background check required.

 


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