Remote Workers' Comp Claims Specialist

Imagine Staffing Technology; United States; À distance; USD 75 000 - 102 000; Temps partiel

Résumé du poste

Imagine Staffing Technology is seeking an experienced Workers’ Compensation Claims Adjuster for a contingent, remote assignment in the United States. Ideal candidates have 3–4 years of Oregon WC claims handling and Oregon certification preferred.

The role involves adjudicating claims, managing documentation, and coordinating return-to-work efforts while maintaining clear communication with all parties involved.

Qualifications

• High School Diploma or GED required.
• Bachelor’s degree preferred.
• Oregon certification preferred.
• 3–4 years of workers’ compensation claims handling experience in Oregon required.
• Equivalent combination of education and claims management experience will be considered.
• Strong understanding of Oregon workers’ compensation regulations, offsets, and disability duration.
• Knowledge of medical management practices and Social Security/Medicare procedures related to workers’ compensation.
• Excellent oral and written communication skills, including the ability to deliver professional presentations.
• Proficient in Microsoft Office and claims management software systems.
• Strong analytical, organizational, and negotiation skills.
• Ability to work both independently and collaboratively in a team environment.
• Commitment to meeting and exceeding service expectations.

Responsabilités

• Manage and adjudicate workers’ compensation claims, including determining compensability, calculating benefits, and ensuring accurate reserves.
• Monitor and file all necessary state-required documentation within statutory deadlines.
• Develop and implement detailed action plans for timely claim resolution, including coordination of return-to-work efforts.
• Approve claim payments and settlements in accordance with authority guidelines.
• Identify and manage subrogation opportunities and negotiate settlements to reduce client exposure.
• Maintain consistent communication with claimants, employers, medical providers, attorneys, and clients.
• Ensure claim files are accurately documented and properly coded.
• Handle complex lifetime medical and defined-period medical claims, including reviewing state and physician filings and evaluating treatment recommendations from utilization reviews.
• Foster and maintain professional client relationships and deliver high-quality service.

Connaissances

Analytical skills

Communication skills

Negotiation skills

Microsoft Office

Claims software

Independent & team work

Formation

High School Diploma or GED

Bachelor’s degree

Oregon certification

Outils

Microsoft Office

Claims management software

Description du poste

Imagine Staffing Technology is seeking an experienced Workers’ Compensation Claims Adjuster for a contingent, remote assignment in the United States. Ideal candidates have 3–4 years of Oregon WC claims handling and Oregon certification preferred.

The role involves adjudicating claims, managing documentation, and coordinating return-to-work efforts while maintaining clear communication with all parties involved.