Job Description

Responsible for acquiring and analyzing workers' compensation, claim information to manage data within scope of responsibility.

Responsibilities

• Gather, analyze, and manage workers' compensation claim data, including medical records and work status updates, to ensure accurate and timely entry.
• Communicate with healthcare providers and stakeholders to collect and verify missing or unclear claim information.
• Collaborate with claim teams and escalate issues to internal or client contacts per SOPs to resolve RTW or job offer concerns.
• Partner with cross-functional teams to validate data, update internal guidelines, and maintain consistency with evolving client protocols.
• Research and improve processes, participate in ad hoc projects, and provide operational support to optimize efficiency and effectiveness.
• Conduct quality assurance reviews and evaluate final claim determinations to ensure compliance with regulatory standards.
• Test tools and workflows, document issues, and provide feedback to support continuous system and process improvement.
• Support year-end OSHA log creation, including reviewing client changes, preparing hours/headcount, and implementing required log updates.

Qualifications

• Bachelor's degree or equivalent.
• At least two (2) years working experience in a claims or insurance management services.
• Excellent oral and written communication skills.
• Highly organized thinking, writing and presenting so that key points are delivered powerfully and clearly to the intended audience.
• Capable of quickly learning new tools and programs.
• Able to manage multiple competing priorities.
• Proficient in MS Excel and PowerPoint.
• Skilled at simplifying complex concepts for a non-technical audience.
• Strives to establish and systematize best practices within team.