Workers' Comp Claims Specialist — Return-to-Work Advocate

SWBC PEO; Bulverde (TX); On-site; USD 65,000 - 90,000; Full time

Job summary

SWBC PEO is seeking a dedicated claims manager to oversee workers' compensation claims from injury reporting through closure. You will partner with clients, injured employees, insurers, adjusters, HR, and payroll to ensure accurate documentation, timely resolutions, and strong customer service.

You will coordinate claims, educate stakeholders on procedures and return-to-work programs, monitor progress, and maintain records.

Qualifications

• Bachelor’s degree in Human Resources, Risk Management and Insurance, related field of study from an accredited four-year college or university preferred.
• Minimum of four (4) years of experience in claims management or related field required.
• Working knowledge of workers' compensation claims processes, return-to-work programs, and claim resolution practices.
• Knowledge of OSHA regulations, workplace safety practices, and accident prevention programs preferred.
• Bilingual (Spanish) language ability is required.

Responsibilities

• Coordinates and manages workers' compensation claims from initial injury reporting through resolution and closure.
• Serves as the primary liaison between client companies, injured employees, insurance carriers, claim adjusters, medical providers, payroll, HR, and internal stakeholders.
• Educates clients and injured employees on workers' compensation procedures, reporting requirements, return-to-work programs, available resources, and their responsibilities throughout the claims process.
• Provides exceptional customer service and guidance while ensuring all parties understand required protocols, next steps, and claim-related obligations.
• Coordinates claim documentation, wage reporting, claim-related communications, and return-to-work activities to support positive claim outcomes.
• Monitors claim progress and collaborates with carriers, adjusters, employers, and medical providers to facilitate efficient claim resolution.
• Reviews claim status with carriers and adjusters, participates in client claim reviews, and assists with the collection and analysis of claims history, loss trends, and risk-related information.
• Maintains accurate claim records, documentation, and reporting.
• Maintain necessary certifications.
• Performs all other duties as assigned.

Skills

Claims management

Bilingual Spanish

OSHA knowledge

Customer service

Analytical

Organizational skills

Education

Bachelor's degree in HR/Risk Management/Insurance

Job description

SWBC PEO is seeking a dedicated claims manager to oversee workers' compensation claims from injury reporting through closure. You will partner with clients, injured employees, insurers, adjusters, HR, and payroll to ensure accurate documentation, timely resolutions, and strong customer service.

You will coordinate claims, educate stakeholders on procedures and return-to-work programs, monitor progress, and maintain records.