Impactful Workers’ Comp Claims Specialist

Ohio BWC (official); Columbus (OH); On-site; USD 36,000 - 47,000; Full time

Job summary

Ohio Bureau of Workers’ Compensation (BWC) is seeking a skilled Claims Examiner to manage a caseload of workers’ compensation claims. You will coordinate with disability management, medical services, MCOs, and employers to set realistic return-to-work expectations and ensure timely processing.

You will conduct initial and subsequent investigations to determine coverage, causality, and eligibility, handling a range of compensation types and working within state regulations.

Qualifications

• Requires 36 months of experience evaluating medical/public assistance benefits.
• Undergrad coursework in business, humanities, social & behavioral sciences or education.
• Alternate: 24 months experience as Workers' Compensation Claims Assistant / CSR / Employer Service Rep.
• 12 months experience as Workers' Compensation Medical Claims Specialist.

Responsibilities

• Manages a caseload of Workers’ Compensation claims: coordinates with stakeholders to set return-to-work expectations.
• Performs initial/subsequent claims investigation & determination within timeframes.
• Processes compensation types including TT, Wage Loss, PPD, Living Maintenance, Lump Sum Developments; handles referrals to IC of Ohio.
• Responds to customer inquiries.
• Follows Ohio Revised Code and BWC policies and procedures.
• Communicates with legal representatives, employers, claimants, etc.

Skills

Claims Examination

Customer Service

Attention to Detail

Teamwork

Education

Undergrad coursework (business/ humanities/ social&behavioral science/ education)

36 months experience evaluating medical/public assistance benefits

24 months experience as Claims/Customer Service/Employer roles

12 months experience as Medical Claims Specialist

Job description

Ohio Bureau of Workers’ Compensation (BWC) is seeking a skilled Claims Examiner to manage a caseload of workers’ compensation claims. You will coordinate with disability management, medical services, MCOs, and employers to set realistic return-to-work expectations and ensure timely processing.

You will conduct initial and subsequent investigations to determine coverage, causality, and eligibility, handling a range of compensation types and working within state regulations.