W/C INSURANCE CLAIMS SPECIALIST 2

State of Arizona; United States; Hybrid; USD 23,488 - 24,245; Full time

Benefits offered by this job

Health and dental insurance

Retirement plan

Paid vacation and holidays

Job summary

The State of Arizona is hiring a W/C Insurance Claims Specialist 2 responsible for auditing incoming claims documents for compliance with workers compensation laws. This role may allow for remote work based on department needs.

Key responsibilities include analyzing claims for compliance, auditing insurers, and managing communications with various stakeholders. The position offers a range of benefits including health insurance, retirement plans, and options for remote work.

Qualifications

• Experience with workers compensation claims management.
• Ability to work under pressure with high accuracy.
• Ability to interpret medical records.

Responsibilities

• Analyze claims documents for compliance.
• Audit insurance carriers and claim adjusters.
• Respond to inquiries from injured workers and attorneys.

Skills

Communication skills

Basic analysis of documents

Critical thinking

Customer service

Time management

Education

Basic knowledge or ability to learn of applicable workers compensation laws

Basic medical terminology

Tools

Microsoft Office Suite

Google Office Suite

Job description

W/C Insurance Claims Specialist 2

Claims Division/Compliance Section, 800 W. Washington Street, Phoenix, AZ 85007

Posting Details

Salary: $17.05 - $17.60 per hour
Grade: 17
Closing Date: June 16, 2026

Job Summary

This position is responsible for auditing incoming claims documents for compliance with applicable workers compensation claims management laws, statutes, and case laws. It may offer the ability to work remotely within Arizona based upon the department's business needs and performance measures.

Job Duties

• Critically analyze submitted forms for compliance and issue appropriate awards when indicated.
• Audit insurance carriers, self‑insured employers, and third‑party administrators adjusting workers’ compensation claims.
• Review all notices, attached medical and/or documentation to verify it supports current change of status and/or calculation of wage and awards; issue the correct corresponding award, notification, or document after analysis.
• Answer incoming phone calls from injured workers, attorneys, interested parties, claim adjusters, medical providers, and the general public.
• Match documents lacking information to existing Commission claims files by researching information in the Claims database or create a new claim file for documents received when there is no existing claim file.
• Provide backup assistance to data entry, error resolution, insurance or combine/delete, as requested.
• Participate in Arizona Management System (AMS) and the daily Huddle board.
• Attend staff meetings, seminars, conferences, and training classes.

Knowledge, Skills & Abilities (KSAs)

Knowledge in:

• Basic knowledge or ability to learn of applicable workers compensation claims management laws, statutes, and case laws.
• Basic medical terminology.
• Microsoft Office Suite; Outlook, Word, Excel, Google Office Suite, Gmail, Sheets, and Docs.
• Basic English.
• Basic mathematics.
• The insurance industry claims adjusting standards and practices.

Skill in:

• Communicating verbally and in writing to resolve disputes with interested parties.
• Basic analysis of insurance, medical, and legal documents.
• Reviewing and interpreting Arizona Workers’ Compensation laws, rules, procedures, and court decisions.
• Critical thinking.
• Time management.
• Initiative and attention to detail.
• Customer service.
• Organizing and planning.
• Basic business process acumen, management skills including workflows and information management.

Ability to:

• Interpret medical records to determine physical limitations for injured workers.
• Manage a heavy workload with a high level of accuracy and productivity.
• Learn computer systems and applications.
• Work well within a diverse and inclusive office environment.
• Process documents in a timely manner and within established productivity standards.
• Prioritize work within established time frames.
• Manage time effectively and meet deadlines.
• Adapt to changing circumstances.
• Demonstrate initiative and attention to detail.
• Exercise discretion and judgment.
• Work well under pressure.
• Perform job responsibilities incorporating lean management and principles of the Arizona Management System.
• Produce high‑quality, nearly error‑free output.

Selective Preference(s)

• Claims adjusting license, certification (WCCA, WCCP, CPCU) or designation relating to workers’ compensation.

Pre‑Employment Requirements

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E‑Verify).

Benefits

The Arizona Department of Administration offers a comprehensive benefits package, including:

• Sick leave
• Vacation with 10 paid holidays per year
• Health and dental insurance
• Retirement plan
• Life insurance and long‑term disability insurance
• Optional employee benefits such as short‑term disability insurance, deferred compensation plans, and supplemental life insurance

Employees may choose a full‑time or part‑time remote work schedule for improved work/life balance. Remote work is a management option and not an employee entitlement or right.

Retirement

Eligible to participate in the state employee health/disability insurance plan and the Arizona State Retirement System (ASRS). Participation may begin immediately or after the 27th week of employment. Employer contributions match employee contributions.

Contact Us

If you have any questions, please call 602‑542‑5559 or email [e-mail].