Hybrid Workers' Comp Claims Ops Specialist

Berkshire Hathaway Guard; Pennsylvania; Hybrid; USD 75,000 - 115,000; Full time

Benefits offered by this job

Hybrid work

No nights

Generous PTO

Day-one benefits

Medical coverage

401(k) plan

Tuition reimbursement

Longevity bonuses

Job summary

Berkshire Hathaway GUARD Insurance Companies is seeking a Workers' Compensation Claims Operations Specialist to support and enhance the performance of our WC claims operation. This role partners with Claims leadership to improve operational effectiveness, drive process improvements, establish quality controls, and support strategic projects aligned with broader P&C claims objectives.

The ideal candidate combines WC claims expertise with analytical skills, process improvement experience, and a

Qualifications

• Bachelor's degree or equivalent experience required.
• 5+ years of Workers' Compensation claims experience preferred.
• Strong understanding of Workers' Compensation claims handling and adjudication practices.
• Ability to analyze complex issues, identify root causes, and develop effective solutions.
• Excellent written and verbal communication skills.
• Strong organizational and project management abilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office applications, including Excel, Word, PowerPoint, and Access.
• Experience driving process improvement, operational excellence, or quality initiatives is highly desirable.

Responsibilities

• Partner with Claims leadership to support daily operations and long-term strategic initiatives.
• Establish and monitor quality assurance programs, claims audits, and performance reporting.
• Identify trends, recurring issues, and workflow bottlenecks, and implement corrective actions.
• Collaborate with training partners to address skill gaps and improve team performance.
• Work with medical networks, cost containment partners, investigative vendors, and other claim service providers to resolve issues and strengthen outcomes.
• Partner with Compliance to maintain audit-ready processes, documentation, and reporting.
• Collaborate with IT to enhance workflows, reporting, business rules, and system functionality.
• Develop scalable, documented processes that improve efficiency and reduce manual effort.
• Lead or support initiatives that improve claims performance, service delivery, and operational standards.

Skills

Workers' compensation claims handling

Data analysis

Process improvement

Quality assurance

Communication skills

Project management

Microsoft Office

Multi-tasking

Collaboration

Education

Bachelor's degree or equivalent experience

Tools

Excel

Word

PowerPoint

Access

Job description

Berkshire Hathaway GUARD Insurance Companies is seeking a Workers' Compensation Claims Operations Specialist to support and enhance the performance of our WC claims operation. This role partners with Claims leadership to improve operational effectiveness, drive process improvements, establish quality controls, and support strategic projects aligned with broader P&C claims objectives.

The ideal candidate combines WC claims expertise with analytical skills, process improvement experience, and a