Workers' Comp Claims Ops Specialist | Hybrid + PTO

Berkshire Hathaway Guard; Wilkes-Barre (Luzerne County); Hybride; USD 65 000 - 90 000; Plein temps

Avantages offerts par ce poste

Hybrid schedule (2 remote / 3 in‑house

No nights, weekends, or holidays

Competitive pay + generous PTO

Medical, dental & vision starting day

401(k), tuition reimbursement & Longet

Résumé du poste

Berkshire Hathaway GUARD Insurance Companies is seeking a Workers' Compensation Claims Operations Specialist to support and enhance the performance of our claims operation. The role partners with Claims leadership to improve operational effectiveness, drive process improvements, and establish quality controls across the WC claims process.

The ideal candidate will bring strong WC claims experience, analytical skills, and a passion for operational excellence.

Qualifications

• Bachelor's degree or equivalent experience required.
• Strong written and verbal communication skills.
• Excellent organizational and project management abilities.
• Experience driving process improvement, operational excellence, or quality initiatives is highly desirable.
• Ability to analyze complex issues, identify root causes, and develop effective solutions.
• Proficiency with Microsoft Office applications, including Excel, Word, PowerPoint, and Access.

Responsabilités

• Partner with Claims leadership to support daily operations and long-term strategic initiatives.
• Establish and monitor quality assurance programs, claims audits, and performance reporting.
• Identify trends, recurring issues, and workflow bottlenecks, and implement corrective actions.
• Collaborate with training partners to address skill gaps and improve team performance.
• Work with medical networks, cost containment partners, investigative vendors, and other claim service providers to resolve issues and strengthen outcomes.
• Partner with Compliance to maintain audit-ready processes, documentation, and reporting.
• Collaborate with IT to enhance workflows, reporting, business rules, and system functionality.
• Develop scalable, documented processes that improve efficiency and reduce manual effort.
• Lead or support initiatives that improve claims performance, service delivery, and operational standards.

Connaissances

Verbal communication

Written communication

Analytical thinking

Process improvement

Project management

Multi-priority management

Microsoft Office (Excel/Word/PowerPoin

Formation

Bachelor's degree or equivalent experience

Outils

Microsoft Office Suite

Description du poste

Berkshire Hathaway GUARD Insurance Companies is seeking a Workers' Compensation Claims Operations Specialist to support and enhance the performance of our claims operation. The role partners with Claims leadership to improve operational effectiveness, drive process improvements, and establish quality controls across the WC claims process.

The ideal candidate will bring strong WC claims experience, analytical skills, and a passion for operational excellence.