Workers Compensation Claims Specialist, CRS

2 weeks ago

Pleasant Garden, United States Holmes Murphy & Associates Full time

Creative Risk Solutions, a division of Holmes Murphy, is dedicated to investing in our employees and fostering a work environment that promotes growth, appreciation, and dedication. We believe that when our employees feel valued, they are better equipped to contribute to the success of our clients and our company.

We are seeking a dynamic Workers' Compensation Claims Specialist who thrives in a collaborative environment and has strong interpersonal communication skills. This role involves servicing captive and self-insured accounts and requires telecommuting. The ideal candidate will have jurisdictional experience in FL, GA, KY, NC, TN, and VA.

Key Responsibilities:

  • Collect and transmit workers' compensation information from various partners.
  • Investigate, evaluate, and resolve lost time Workers' Compensation claims, including litigated claims.
  • Mediate between insured parties and the insurance company, including coverage research.
  • Maintain accurate claim information in the system, including final settlements.
  • Generate daily indemnity and medical payment checks.
  • Compile and interpret Workers' Compensation reports as needed.
  • Participate in onsite and virtual claim reviews and Risk Control Workshops
  • Adjudicate medical only and lost time claims across multiple jurisdictions.
  • Ensure procedural consistency in claims handling.
  • Obtain necessary licensing for claims jurisdictions.
Skills and Abilities:
  • In-depth knowledge of Workers' Compensation insurance coverage and claims processing.
  • Ability to manage multiple tasks and work under emotional conditions.
  • Professionalism, confidentiality, and strong interpersonal skills.
  • Proficiency in various software programs.
  • Compliance with HMA's Client Privacy Policy, HIPAA regulations, and E&O procedures.
Qualifications:
  • Education: High School diploma required; college education preferred.
  • Experience: Minimum of five years in claims handling with a strong background in Workers' Compensation.
  • Jurisdictional expertise and required licensing in FL, GA, KY, NC, TN, and VA.
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.
  • DE&I programs - Holmes Murphy is committed to celebrating every employee's unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish
  • 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?

Holmes Murphy & Associates is an Equal Opportunity Employer.

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