Workers Compensation Claims Operations Specialist

Berkshire Hathaway GUARD Insurance Companies; Wilkes-Barre (Luzerne County); Hybride; USD 65 000 - 90 000; Plein temps

Avantages offerts par ce poste

Hybrid schedule: 2 days remote / 3 in‑

Hybrid schedule

Predictable hours (no nights, weekends

Competitive pay + generous PTO

Medical, dental & vision starting day

401(k), tuition reimbursement &lon v g

Résumé du poste

Berkshire Hathaway GUARD Insurance Companies seeks a Workers' Compensation Claims Operations Specialist to help optimize the WC claims operation. You will work with Claims leadership to improve processes, establish quality controls, and support strategic projects aligned with broader P&C Claims goals.

The role requires WC claims expertise, analytical skills, and a drive for operational excellence, with a hybrid schedule (2 days remote, 3 in‑office) and opportunities for growth.

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.
• Excellent written and verbal communication skills.
• Strong organizational and project management abilities.

Responsabilités

• Support daily operations and long-term strategic initiatives with Claims leadership.
• 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

Analytical skills

Communication skills

Organizational skills

Project management

Problem solving

Formation

Bachelor's degree or equivalent experience

Outils

Microsoft Office

Description du poste

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.

Overview

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.

Location

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.