Workers’ Compensation Administrative Lead

Plethy

United States

Remote

USD 60,000 - 90,000

Full time

12 days ago

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Job summary

Plethy, Inc. is seeking a Workers' Compensation Administrative Lead to coordinate the WC MSK Team's operations in a remote US-based setting.

You will liaise with adjusters, nurse case managers, and internal stakeholders to ensure compliant, timely documentation and workflows. You will support clinical escalations, manage daily operational tasks, and help implement process improvements across the WC function while maintaining HIPAA standards and strict data governance.

Qualifications

  • 3+ years in Workers' Compensation clinical operations or case management support (clinical, administrative, or claims-related).
  • Strong understanding of WC workflows, jurisdictional nuances, and documentation expectations.
  • Excellent organizational skills and ability to manage multiple priorities.
  • Strong written and verbal communication skills.
  • Proficiency with EMRs, digital health platforms, and Microsoft Office.
  • Ability to work independently and collaboratively in a remote environment.
  • Familiarity with WC terminology, treatment guidelines, and communication pathways.
  • Process-driven mindset with a passion for improving workflows and operational efficiency.
  • Empathy-driven approach to supporting injured workers and clinical staff.
  • Adaptability in a growth-stage digital health company.

Responsibilities

  • Serve as the primary administrative point of contact for the Workers' Compensation MSK Team.
  • Support communication with adjusters, nurse case managers, providers, and internal stakeholders.
  • Assist with Workers' Compensation documentation workflows and ensure timely, accurate completion.
  • Support clinical escalations by routing information appropriately, ensuring follow-up, and maintaining documentation integrity.
  • Manage clinical escalations as needed during PTO and staff outages.
  • Provide daily operational support to Recupe Coaches, Onboarding Coordinators, Team Leads, Supervisors, and the WC Operations Manager.
  • Assist with quality and compliance activities, including data gathering, documentation review, and audit preparation.
  • Monitor operational metrics to identify workflow gaps and opportunities for improvement.
  • Collaborate with leadership to implement process improvements that enhance efficiency, compliance, and the injured worker experience.
  • Support execution and implementation of the Workers' Compensation Business Plan.
  • Maintain strict HIPAA compliance and uphold all regulatory and organizational standards.
  • Assist with data collection, reporting, documentation management, and cross-department communication.
  • Contribute to the development and refinement of SOPs, workflow guides, and best practices for WC clinical operations.
  • Demonstrate strong administrative judgment and the ability to anticipate operational needs.
  • Maintain high accuracy and attention to detail in documentation and communication.
  • Manage multiple priorities and deadlines in a fast-paced digital health environment.
  • Communicate clearly and professionally with clinicians, adjusters, internal teams, and external partners.
  • Uphold a process-driven mindset with a commitment to continuous improvement.
  • Approach interactions with empathy, supporting both injured workers and clinical staff.
  • Work independently while contributing effectively to a collaborative, mission-driven team.

Skills

WC workflows
Documentation
HIPAA compliance
EMRs
MSK operations

Tools

Microsoft Office
EMR systems
Digital health platforms
Data reporting tools

Job description

Plethy, Inc.

Location: Remote (US)
Type: Full-Time

The Workers' Compensation Administrative Lead supports the operational backbone of Plethy's Workers' Compensation MSK Team. This role ensures smooth coordination across Recupe Coaches, Onboarding Coordinators, Team Leads, Supervisors, and the Workers' Compensation Operations Manager. The Lead maintains accuracy, compliance, and timeliness within a fast-paced digital MSK environment and serves as a key administrative partner in delivering high-quality, jurisdictionally compliant support to injured workers.

Responsibilities
Workers' Compensation Operations & Compliance
  • Serve as the primary administrative point of contact for the Workers' Compensation MSK Team.
  • Support communication with adjusters, nurse case managers, providers, and internal stakeholders.
  • Assist with Workers' Compensation documentation workflows and ensure timely, accurate completion.
  • Support clinical escalations by routing information appropriately, ensuring follow-up, and maintaining documentation integrity.
  • Manage clinical escalations as needed during PTO and staff outages
MSK Operations Support
  • Provide daily operational support to Recupe Coaches, Onboarding Coordinators, Team Leads, Supervisors, and the WC Operations Manager.
  • Assist with quality and compliance activities, including data gathering, documentation review, and audit preparation.
  • Monitor operational metrics to identify workflow gaps and opportunities for improvement.
  • Collaborate with leadership to implement process improvements that enhance efficiency, compliance, and the injured worker experience.
  • Support execution and implementation of the Workers' Compensation Business Plan.
Administrative & Cross-Team Coordination
  • Maintain strict HIPAA compliance and uphold all regulatory and organizational standards.
  • Assist with data collection, reporting, documentation management, and cross-department communication.
  • Contribute to the development and refinement of SOPs, workflow guides, and best practices for WC clinical operations.
  • Demonstrate strong administrative judgment and the ability to anticipate operational needs.
  • Maintain high accuracy and attention to detail in documentation and communication.
  • Manage multiple priorities and deadlines in a fast-paced digital health environment.
  • Communicate clearly and professionally with clinicians, adjusters, internal teams, and external partners.
  • Uphold a process-driven mindset with a commitment to continuous improvement.
  • Approach interactions with empathy, supporting both injured workers and clinical staff.
  • Work independently while contributing effectively to a collaborative, mission-driven team.
Qualifications
  • 3+ years of experience in Workers' Compensation clinical operations or case management support (clinical, administrative, or claims-related).
  • Strong understanding of WC workflows, jurisdictional nuances, and documentation expectations.
  • Excellent organizational skills and ability to manage multiple priorities.
  • Strong written and verbal communication skills.
  • Proficiency with EMRs, digital health platforms, and Microsoft Office.
  • Ability to work independently and collaboratively in a remote environment.
  • Familiarity with WC terminology, treatment guidelines, and communication pathways.
  • Process-driven mindset with a passion for improving workflows and operational efficiency.
  • Empathy-driven approach to supporting injured workers and clinical staff.
  • Adaptability and comfort working in a mission-driven, growth-stage digital health company.

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