Workers Compensation Claims Operations Specialist

GUARD; Pennsylvania; Hybride; USD 75 000 - 115 000; Plein temps

Avantages offerts par ce poste

Hybrid work

No nights

Generous PTO

Day-one benefits

Medical coverage

401(k) plan

Tuition reimbursement

Longevity bonuses

Résumé du poste

Berkshire Hathaway GUARD Insurance Companies is seeking a Workers' Compensation Claims Operations Specialist to support and enhance the performance of our WC claims operation. This role partners with Claims leadership to improve operational effectiveness, drive process improvements, establish quality controls, and support strategic projects aligned with broader P&C claims objectives.

The ideal candidate combines WC claims expertise with analytical skills, process improvement experience, and a

Qualifications

• Bachelor's degree or equivalent experience required.
• 5+ years of Workers' Compensation claims experience preferred.
• Strong understanding of Workers' Compensation claims handling and adjudication practices.
• Ability to analyze complex issues, identify root causes, and develop effective solutions.
• Excellent written and verbal communication skills.
• Strong organizational and project management abilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office applications, including Excel, Word, PowerPoint, and Access.
• Experience driving process improvement, operational excellence, or quality initiatives is highly desirable.

Responsabilités

• Partner with Claims leadership to support daily operations and long-term strategic initiatives.
• Establish and monitor quality assurance programs, claims audits, and performance reporting.
• Identify trends, recurring issues, and workflow bottlenecks, and implement corrective actions.
• Collaborate with training partners to address skill gaps and improve team performance.
• Work with medical networks, cost containment partners, investigative vendors, and other claim service providers to resolve issues and strengthen outcomes.
• Partner with Compliance to maintain audit-ready processes, documentation, and reporting.
• Collaborate with IT to enhance workflows, reporting, business rules, and system functionality.
• Develop scalable, documented processes that improve efficiency and reduce manual effort.
• Lead or support initiatives that improve claims performance, service delivery, and operational standards.

Connaissances

Workers' compensation claims handling

Data analysis

Process improvement

Quality assurance

Communication skills

Project management

Microsoft Office

Multi-tasking

Collaboration

Formation

Bachelor's degree or equivalent experience

Outils

Excel

Word

PowerPoint

Access

Description du poste

Overview

Good Things Start Here.

Good things are happening at Berkshire Hathaway GUARD Insurance Companies—an A+ (Superior) rated, nationwide Property & Casualty insurer backed by Berkshire Hathaway. With supportive leadership, collaborative teams, and opportunities to grow, GUARD is a place where people build meaningful, long‑term careers.

Good Things You Can Count On.

• Hybrid schedule: 2 days remote / 3 in‑office
• Predictable hours (no nights, weekends, or holidays)
• Competitive pay + generous PTO
• Medical, dental & vision starting day one
• 401(k), tuition reimbursement & longevity bonuses

Responsibilities

Berkshire Hathaway GUARD Insurance Companies is seeking a Workers' Compensation Claims Operations Specialist to support and enhance the performance of our Workers' Compensation Claims operation. This role partners closely with Claims leadership to improve operational effectiveness, drive process improvement initiatives, establish quality controls, and support strategic projects that align with broader Property & Casualty Claims objectives.

The ideal candidate combines strong workers' compensation claims expertise with analytical skills, process improvement experience, and a passion for operational excellence.

What You'll Do

• Partner with Claims leadership to support daily operations and long-term strategic initiatives.
• Establish and monitor quality assurance programs, claims audits, and performance reporting.
• Identify trends, recurring issues, and workflow bottlenecks, and implement corrective actions.
• Collaborate with training partners to address skill gaps and improve team performance.
• Work with medical networks, cost containment partners, investigative vendors, and other claim service providers to resolve issues and strengthen outcomes.
• Partner with Compliance to maintain audit-ready processes, documentation, and reporting.
• Collaborate with IT to enhance workflows, reporting, business rules, and system functionality.
• Develop scalable, documented processes that improve efficiency and reduce manual effort.
• Lead or support initiatives that improve claims performance, service delivery, and operational standards.

Qualifications

• Bachelor's degree or equivalent experience required.
• 5+ years of Workers' Compensation claims experience preferred.
• Strong understanding of Workers' Compensation claims handling and adjudication practices.
• Demonstrated ability to analyze complex issues, identify root causes, and develop effective solutions.
• Excellent written and verbal communication skills.
• Strong organizational and project management abilities.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office applications, including Excel, Word, PowerPoint, and Access.
• Experience driving process improvement, operational excellence, or quality initiatives is highly desirable.

This role will ideally be based out of the following location: Wilkes‑Barre, PA.

Interview Integrity Notice: Berkshire Hathaway GUARD is committed to a fair and consistent hiring process. Candidates are expected to participate independently in interviews. Unauthorized recording, transcription, AI note-taking, or AI interview assistance tools may not be used during interviews without prior approval.