Workers' Comp Claims Specialist

churchmutual; Wisconsin; On-site; USD 42,000 - 62,000; Full time

Job summary

Church Mutual is seeking a Claims Processor to handle workers' compensation claims with accuracy and service focus. Responsibilities include processing new claims, verifying coverage, entering data, establishing reserves, and issuing payments in line with state laws and internal guidelines.

The ideal candidate has 2 years in insurance processing or equivalent customer service, familiarity with workers' compensation, and strong communication skills to coordinate with insureds and claimants by

Qualifications

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

Responsibilities

• Process newly reported workers compensation claims, initiate basic claim investigation, and redirect complex claims as needed.
• Perform Claim Processing System entry and maintenance: file setup, coverage verification, coding, reserves, and payments.
• Verify coverage and determine our obligations to insureds/claimants.
• Review claims to determine type, documentation, amount due, and reserves.
• Establish and monitor case reserves throughout the claim life cycle.
• Refer subrogation opportunities to the Subrogation Specialist when appropriate.
• Provide additional instruction to insured or request further information.
• Submit state filings and issue required notices and letters.
• Complete the claim process by reviewing documentation and making payments.
• Assist other claim handlers as requested.

Skills

Insurance processing

Customer service

Attention to detail

Communication skills

Education

High school diploma

Associate degree preferred

Tools

Claim Processing System

Job description

Church Mutual is seeking a Claims Processor to handle workers' compensation claims with accuracy and service focus. Responsibilities include processing new claims, verifying coverage, entering data, establishing reserves, and issuing payments in line with state laws and internal guidelines.

The ideal candidate has 2 years in insurance processing or equivalent customer service, familiarity with workers' compensation, and strong communication skills to coordinate with insureds and claimants by