Workers Compensation Claims Assistant I

AvonRisk; Houston (TX); On-site; USD 30,000 - 42,000; Full time

Benefits offered by this job

Medical benefits

HSA/FSA plans

Life and disability insurance

401(k) with company match

Paid time off and holidays

Learning and development opportunities

Employee assistance resources

Job summary

AvonRisk is seeking a clerical operations support professional to assist assigned Claims Specialist(s). You will prepare new claims files, process benefit payments, issue notices, and maintain communications with providers and employers.

This role reports to the unit Claims Supervisor and requires 1-2 years related experience or a GED, with strong problem solving and customer service skills; the company offers a comprehensive benefits package.

Qualifications

• Problem solving skills with ability to analyze information and resolve issues
• Strong customer service orientation and ability to handle difficult situations
• Team player who supports others to achieve goals

Responsibilities

• Prepares new claims files
• Calculates TTD, Wage Loss, VRMA and PD benefits
• Issues compensation payments on diary schedule
• Issues Benefit Notices
• Doctor status calls and Employee/Employer contact calls
• Employer contact calls to confirm light duty or modified work
• Works with Claims Specialist to complete clerical tasks
• Prepares litigation documents such as C&R, Stipulations, Answers, etc
• Prepares rehabilitation forms for filing with the rehabilitation unit
• Handles provider inquiries about unpaid bills and related questions
• Reviews Mail and processes direct pays such as Mileage Reimbursement
• Performs File and Serve duties as needed
• Notepad documentation in Portal
• Sets up income benefit check schedules under supervision
• Mail claim documents and checks timely
• Drafts template letters to support the adjusting team
• Documents incoming medical records
• Sets notifications of document receipt in the Risk Management Information System
• Performs other clerical functions as assigned

Skills

Problem Solving

Customer Service

Team Work

Education

High School Diploma or GED

Job description

AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers’ compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare, InterMed, George Hills, and AS&G Claims Administration, we’re a people-focused, operations-driven organization that prioritizes reasonable caseloads, strong training, collaborative teams, and expert support. We invest in tools and workflows that reduce friction—not increase volume—and create real career paths for professionals who want to grow their careers or move into leadership. At AvonRisk, you’re part of a team that values good judgment, curiosity, and accountability, and gives you the support to succeed.

Summary:

Reports directly to the unit Claims Supervisor but takes primary direction for the assigned Claims Specialist(s). Responsible for providing clerical operations support to assigned Claims Specialist(s).

Essential Duties and Responsibilities:

• Prepares new claims files
• Calculates TTD, Wage Loss, VRMA and PD benefits
• Issues compensation payments on diary schedule
• Issues Benefit Notices
• Doctor status calls and Employee/Employer contact calls
• Employer contact calls to confirm light duty/modifies work
• Works closely with Claims Specialist to complete clerical assignments
• Prepares litigation documents such as C&R, Stipulations, Answers, etc
• Prepares rehabilitation forms for filing with the rehabilitation unit
• Handle calls from providers inquiring about unpaid bills and bill related questions
• Review Mail and process direct pays bills such as Mileage Reimbursement
• File and Serve duties (as needed)
• Notepad documentation in Portal

Set up income benefit check schedules under the close supervision of the handling adjuster

Mail claim documents and checks in a timely manner

Draft template letters (Plain Language Notices) to support the adjusting team

Document incoming medical records

Set notifications of document receipt to adjusters from within the Risk Management Information System

Other clerical functions, as assigned

Requirements

Competency:

To perform the job successfully, an individual should demonstrate the following competencies:

• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Team Work - Supports everyone's efforts to succeed.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:

High school diploma or general education degree (GED); or 1-2 years related experience and/or training; or equivalent combination of education and experience.

Salary Range:

The salary range listed is an estimate. Actual compensation will be determined based on several factors such as a candidate’s experience, qualifications, skill set, and work location.

Benefits:

We take care of our people so they can take care of their work and their teams. AvonRisk offers a competitive, people first benefits package designed to support your health, financial security, and career growth, including:

• Comprehensive medical, dental, and vision benefits
• Company contributions to HSA and FSA plans
• Employer paid life and disability insurance
• 401(k) with company match
• Paid time off (PTO) and company paid holidays
• Learning and development opportunities that support real career advancement
• Employee assistance resources and a supportive culture that values balance and wellbeing

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.