Workers' Comp Claims Specialist: Risk & Onboarding Lead

HRDelivered; United States; Remote; USD 42.000 - 64.000; Vollzeit

Zusammenfassung

HRDelivered is seeking a Workers' Compensation Claim Specialist to manage the full lifecycle of claims for PEO clients, serving as the primary contact between clients, carriers, adjusters, and the RM team. The role supports client onboarding, regulatory compliance, carrier reporting, and risk education.

Responsibilities include filing claims, maintaining records in CHR and PRISM, coordinating medical appointments, and preparing wage statements.

Qualifikationen

• 1–2 years of workers' compensation claims experience, preferably in a PEO environment.
• 1 year of administrative experience in a fast-paced business environment.
• PRISM experience preferred.
• Proficiency in Microsoft Excel (required), Word, and Outlook.
• High school diploma required; associate degree preferred.

Aufgaben

• Receive, review, and file new workers' compensation claims with the carrier, copying the RM team on all communications.
• Set up and maintain claim files in the CHR management system and PRISM.
• Provide adjusters with complete claim documentation and file all ongoing correspondence in the claim record.
• Coordinate with clients, adjusters, and the RM team on medical appointments, treatment records, and return-to-work status.
• Track drug test results and communicate outcomes to the RM team, adjuster, and client.
• Calculate wage statements for claim processing.
• Monitor open claims, follow up on pending items, and resolve claim-related issues and inquiries.

Kenntnisse

Analytical skills

Problem-solving

Communication

Time management

Detail-oriented

Ausbildung

High school diploma

Associate degree preferred

Tools

PRISM

Excel

Word

Outlook

Jobbeschreibung

HRDelivered is seeking a Workers' Compensation Claim Specialist to manage the full lifecycle of claims for PEO clients, serving as the primary contact between clients, carriers, adjusters, and the RM team. The role supports client onboarding, regulatory compliance, carrier reporting, and risk education.

Responsibilities include filing claims, maintaining records in CHR and PRISM, coordinating medical appointments, and preparing wage statements.