Claims Management Specialist

Kforce Inc; Bulverde (TX); On-site; USD 64,000 - 88,000; Full time

Job summary

Kforce is seeking a Claims Management Specialist in Bulverde, TX to oversee the workers' compensation claims lifecycle. You will be the main point of contact for employees, carriers, medical providers, HR, and payroll to ensure timely resolution and regulatory compliance.

Ideal candidates bring 4+ years of claims experience, bilingual Spanish, and strong communication and problem-solving skills to deliver accurate records, effective RTW programs, and exceptional service across stakeholders.

Qualifications

• Bachelors degree in HR, Risk Management, Insurance, or related field preferred.
• 4+ years of workers' compensation claims management or related experience.
• Knowledge of OSHA regulations and workplace safety preferred.
• Bilingual Spanish required.
• Excellent communication, organizational, problem-solving, and customer service skills.

Responsibilities

• Manage workers' compensation claims throughout the entire claim lifecycle.
• Serve as the primary liaison between employees, employers, insurance carriers, adjusters, and medical providers.
• Educate employees and stakeholders on claims processes, reporting requirements, return-to-work programs, and available resources.
• Coordinate documentation, wage reporting, claim communications, and return-to-work activities.
• Monitor claim progress and collaborate with carriers, adjusters, and providers to facilitate favorable outcomes.
• Participate in claim reviews and assist with analyzing claim trends and loss history.
• Maintain accurate claim records and reporting.
• Support compliance with workers' compensation regulations and company policies.

Skills

Bilingual Spanish

Communication

Organization

Problem-solving

Customer service

Education

Bachelor’s degree in HR/Risk/Insurance

Job description

Responsibilities

Kforce has a client in Bulverde, TX that is seeking a Claims Management Specialist. Summary: We are seeking an experienced professional to manage workers' compensation claims from initial injury reporting through claim closure. This role serves as a key point of contact for employees, insurance carriers, medical providers, HR, payroll, and other stakeholders to ensure timely claim resolution, compliance, and exceptional customer service. This role offers the opportunity to make a meaningful impact by supporting employees, managing risk, and delivering outstanding service throughout the claims process.

• Manage workers' compensation claims throughout the entire claim lifecycle
• Serve as the primary liaison between employees, employers, insurance carriers, adjusters, and medical providers
• Educate employees and stakeholders on claims processes, reporting requirements, return-to-work programs, and available resources
• Coordinate documentation, wage reporting, claim communications, and return-to-work activities
• Monitor claim progress and collaborate with carriers, adjusters, and providers to facilitate favorable outcomes
• Participate in claim reviews and assist with analyzing claim trends and loss history
• Maintain accurate claim records and reporting
• Support compliance with workers' compensation regulations and company policies

Requirements

• Bachelor's degree in Human Resources, Risk Management, Insurance, or a related field preferred
• 4+ years of workers' compensation claims management or related experience
• Strong knowledge of workers' compensation processes, claim resolution, and return-to-work programs
• Knowledge of OSHA regulations and workplace safety practices preferred
• Bilingual Spanish required
• Excellent communication, organizational, problem-solving, and customer service skills
• Ability to manage multiple priorities while maintaining attention to detail

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.