Workers' Compensation Claims Specialist (REMOTE - ME, CT, PA, RI)

Holmes Murphy; Pennsylvania; On-site; USD 58,000 - 99,000; Full time

Benefits offered by this job

Parental leave

Tuition reimbursement

401k profit sharing

Generous time off

Volunteer time off

Diversity & inclusion program

Job summary

Holmes Murphy’s Creative Risk Solutions unit seeks a Workers’ Compensation Claims Specialist to manage and resolve WC claims with strong client service focus. You will handle information flow, investigations, and settlements while collaborating with insureds and insurers in a dynamic team environment.

The role requires 3-5 years of WC claims experience, licensing in WC, and the ability to learn diverse software systems.

Qualifications

• High school diploma; college degree preferred.
• 3-5 years claims experience with Workers’ Compensation.
• Active state WC license or ability to obtain within 3 months.
• Proficient knowledge of WC coverage and claims processing procedures.
• Adjudicate lost time claims across multiple jurisdictions; learn and adapt to software.

Responsibilities

• Receives and transmits workers’ comp information from insureds, claimants, and staff.
• Investigates, evaluates, and resolves lost time WC claims, including litigated claims.
• Mediates between insured and insurer, researching coverage issues.
• Enters and maintains accurate data in claim systems, including settlements.
• Generates indemnity and medical payments checks daily.
• Develops and enforces procedural consistency in CRS claims handling.

Skills

WC claims knowledge

Claims processing

Licensing (WC)

Software proficiency

Multi-jurisdiction adjudication

Education

High school diploma

College degree preferred

AIC designation

CPCU designation

Tools

Claims software

Job description

Job Description

Step into a role where your client service expertise makes a meaningful impact. We are looking to add a Workers’ Compensation Claims Specialist to join our Creative Risk Solutions team. Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently-empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients.

Essential Responsibilities

• Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
• Investigates, evaluates, and resolves lost time Workers’ Compensation claims, including litigated claims.
• Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues.
• Enters and maintains accurate information on a computer system during the claim process, to include final settlement information.
• Generates checks for indemnity and medical payments daily.
• Develops and monitors consistency in procedural matters of claims handling process within CRS.
• Willingness to become licensed if required in jurisdiction where claims are handled.

Qualifications

• Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU.
• Experience: 3-5 years claims experience with strong background in Workers’ Compensation claims handling.
• Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire.
• Skills: An ideal candidate will have proficient knowledge of Workers’ Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs.
• Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience.

Here’s a Little Bit About Us

Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization’s success by effectively influencing and uplifting team members.

Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as:

• Paid Parental Leave and supportive New Parent Benefits - We know being a working parent is hard, and we want to support our employees in this journey!
• Company paid continuing Education & Tuition Reimbursement - We support those who want to develop and grow.
• 401k Profit Sharing - Each year, Holmes Murphy makes a lump sum contribution to every full-time employee’s 401k. This means, even if you’re not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for.
• Generous time off practices in addition to paid holidays - Yes, we actually encourage employees to use their time off, and they do. After all, you can’t be at your best for our clients if you’re not at your best for yourself first.
• Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you - Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you.
• Inclusion & Belonging Programs - Holmes Murphy is committed to celebrating every employee’s unique potential. Through inclusion and belonging initiatives, titled Uniquely United, not only do we offer employees a paid Diversity Day time-off option, but we also have a Uniquely United Committee, Employee Resource Groups, and development programs to advance our culture of belonging. We encourage employees to engage in ways that are meaningful to them to enhance their overall experience!
• Consistent merit increase and promotion opportunities - Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important - not only with your financial wellbeing, but also your career wellbeing.
• Discretionary bonus opportunity - Yes, there is an annual opportunity to make more money. Who doesn’t love that?!

At this time, we are not considering candidates who require any type of immigration sponsorship now or in the future. This includes candidates whose current work authorization is temporary or set to expire and who would require employer participation in any renewal, extension, or new authorization process to continue employment.

The salary range for this role is $57,500- $98,900. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development.

Holmes Murphy & Associates is an Equal Opportunity Employer.