Senior Workers' Compensation Claims Specialist

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); On-site; USD 55,000 - 75,000; Full time

Job summary

Cape Fear Valley Medical Center in Fayetteville, NC is seeking a Risk Management professional to process workers' compensation claims. You will investigate incidents, manage complex cases, and ensure regulatory compliance with NC workers' compensation law.

The role requires strong communication, confidentiality, and data analysis skills, with responsibility for approving payments and maintaining accurate records in a claims system.

Qualifications

• Associate’s degree in business or a related field required.
• North Carolina Claims Adjuster's License in good standing required.
• 4 years’ experience in workers' compensation claims administration required.
• 3 years’ experience in safety, legal, and insurance environment preferred.
• Proficiency with MS Office and a claims database (e.g., iVOS).

Responsibilities

• Investigate and analyze data to determine compensability.
• Manage and maintain a caseload of complex lost-time claims.
• Attend workers' compensation mediations and NC Industrial Commission hearings.
• Approve disability and medical payments; review related bills.
• Maintain strict confidentiality of all documentation and materials.

Skills

Communications

Analytical skills

Confidentiality

Time management

Education

Associate degree in business or related field

Bachelor’s degree preferred

Tools

Microsoft Office

iVOS / insurance database

Job description

Cape Fear Valley Medical Center in Fayetteville, NC is seeking a Risk Management professional to process workers' compensation claims. You will investigate incidents, manage complex cases, and ensure regulatory compliance with NC workers' compensation law.

The role requires strong communication, confidentiality, and data analysis skills, with responsibility for approving payments and maintaining accurate records in a claims system.