Workers' Comp Claims Specialist

Church Mutual Insurance Company, S.I.; Milwaukee (WI); On-site; USD 45,000 - 60,000; Full time

Job summary

Church Mutual Insurance Company, S.I. is seeking a Claims Processor to handle workers' compensation claims, verify coverage, document necessary information, and issue payments in accordance with state and federal laws and company guidelines.

The role requires strong customer service, attention to detail, and the ability to direct complex claims to senior staff as needed. Milwaukee-based office, on‑site work with standard business hours.

Qualifications

• Two years of insurance processing and/or equivalent customer service work experience.
• Prior workers compensation claim processing experience is preferred.
• Proficient keyboarding skills.

Responsibilities

• Process newly reported workers compensation claims, initiate basic claim investigation, and redirect complex claims to a higher level Claim Representative as required.
• Perform Claim Processing System entry and maintenance, including file setup, coverage verification, applicable coding, establishing reserves, and issuing payments.
• Verify coverage and determine our obligation(s) to the insured and/or claimant.
• Review claims to determine type of claim presented, claim documentation/evidence presented, amount of claim, or amount due.
• Establish and monitor case reserves for adequacy during the life of the claim.
• Review loss for subrogation potential and refer to the Subrogation Specialist, if appropriate.
• Provide additional instruction to insured or request additional information.
• Submit necessary state filings and create and send appropriate required state notices and letters.
• Complete the claim process by obtaining and reviewing support documentation in accordance with existing state laws and fee schedules and make appropriate payments.
• Assist other claim handlers as requested.

Skills

Insurance processing

Customer service

Claims handling

Education

High school diploma or equivalent

Associate degree in insurance or business

Insurance/medical terminology courses desirable

Job description

Church Mutual Insurance Company, S.I. is seeking a Claims Processor to handle workers' compensation claims, verify coverage, document necessary information, and issue payments in accordance with state and federal laws and company guidelines.

The role requires strong customer service, attention to detail, and the ability to direct complex claims to senior staff as needed. Milwaukee-based office, on‑site work with standard business hours.