Senior Workers' Comp Claims Specialist

State-of-Missour; Jefferson City (MO); On-site; USD 50,000 - 70,000; Full time

Job summary

The State of Missouri is seeking a mid-level claims professional to assist injured state employees with workers' compensation claims. You will communicate with injured workers, state and public entities, medical and legal professionals, and insurers to provide one-on-one support throughout claims processing.

The role includes reviewing medical documentation, calculating benefits, and coordinating with healthcare providers under a comprehensive state benefits program.

Qualifications

• Bachelor's degree or technical experience in underwriting or administration of workers' compensation, medical, property, liability, or casualty claims.
• Knowledge of claims handling and workers’ compensation.
• Ability to interpret and explain rules, regulations, and policies.
• Ability to perform mathematical calculations, interpret data, maintain accuracy, and work independently.

Responsibilities

• Correspond with injured workers and employers.
• Calculate workers' compensation benefits.
• Review medical files and documents.
• Ensure authorized treatment in relation to an injury and approve medical bills.
• Respond to attorney requests.
• Ensure files are kept secure and confidential.
• Monitor medications of injured workers and work with pharmacy network.
• Utilize the Early Return to Work Program.

Skills

claims handling

workers’ compensation

customer service

communication

interpersonal interaction

interpret rules and policies

data interpretation

Education

Bachelor's degree / technical experience

Job description

The State of Missouri is seeking a mid-level claims professional to assist injured state employees with workers' compensation claims. You will communicate with injured workers, state and public entities, medical and legal professionals, and insurers to provide one-on-one support throughout claims processing.

The role includes reviewing medical documentation, calculating benefits, and coordinating with healthcare providers under a comprehensive state benefits program.