Workers Compensation Specialist
Job Summary
We are seeking a knowledgeable and detail-oriented Workers’ Compensation Representative to manage workers’ compensation claims and ensure timely, accurate processing in compliance with state and federal regulations. The Workers’ Compensation Rep will serve as the primary liaison between employees, medical providers, insurance carriers, and internal departments to facilitate claims, monitor cases, and support injured employees through the process.
Key Responsibilities
Coordinate and manage the end-to-end workers’ compensation claims process.
Act as the primary point of contact for employees, supervisors, medical providers, and insurance adjusters.
File and track claims with insurance carriers, ensuring timely reporting and documentation.
Review medical reports, work restrictions, and treatment plans to support case management.
Communicate with employees regarding claim status, benefits, and return-to-work expectations.
Assist in developing modified duty/return-to-work programs in collaboration with HR and supervisors.
Maintain accurate and confidential claim records, reports, and correspondence.
Monitor compliance with state and federal workers’ compensation laws and internal policies.
Analyze claims trends and provide recommendations to reduce workplace injuries and costs.
Support safety and risk management initiatives to promote a safe work environment.
Qualifications
High school diploma or GED required; Associate’s or Bachelor’s degree in Business, HR, Healthcare, or related field preferred.
2–3 years of experience in workers’ compensation claims, case management, or insurance claims handling.
Strong knowledge of workers’ compensation regulations and claims procedures.
Excellent communication and interpersonal skills with a customer-service mindset.
Strong organizational skills and attention to detail with the ability to manage multiple cases.
Proficiency in claims management systems, EMR/EHR, and Microsoft Office Suite.
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