Claims Operations Senior Consultant

1 week ago


Richmond, Virginia, United States Commonwealth of Virginia Full time

Job Responsibilities

The Commonwealth of Virginia is seeking a Senior Claims Analysis Specialist to meticulously evaluate correspondence, medical documentation, claims, electronically transmitted data, agreement forms, and various other records to ensure thorough follow-up until all issues are resolved. This role requires precise documentation of each interaction and collaboration with supervisory staff when timely resolutions are not achievable. Additionally, the incumbent will manage the processing of agreement forms and provide essential support and follow-up for order responses. Other duties include assisting in the facilitation of issue resolution and offering support to clients and interdepartmental teams as necessary. A successful candidate must pass a criminal background check.

Compensation Framework

The Commonwealth of Virginia offers a competitive and distinctive compensation structure for this position, classified as pay grade 7 within a 14-grade pay system. Our roles are not categorized under DHRM's pay bands.

Telework Policy

Currently, our agency operates under a hybrid telework model. While remote work is available, candidates should be prepared to report to our Headquarters or Regional Office as required. Telework arrangements will be determined by the Director or Manager based on departmental needs. Upon hiring, all training and orientation will take place at the Headquarters Office.

Overview of the Commonwealth of Virginia

The agency is led by a Senior Leadership team, which includes three Commissioners, an Executive Director, and a Chief Deputy Commissioner. The Commonwealth of Virginia has been recognized as a Top Workplace both regionally and nationally. Our mission is to provide outstanding services to injured workers, crime victims, employers, and related sectors by resolving disputes and executing our responsibilities with integrity. Our vision is to be a leader in effectiveness and innovation among state agencies. Employees embody seven core values: innovation, respect, accountability, reliability, impartiality, integrity, and effectiveness.

We are a certified state agency under the "Virginia Values Veterans" (V3) program, supporting Veterans and members of the Reserves and National Guard. We encourage Veterans and their spouses to indicate their status in their applications. The Commonwealth of Virginia is an Equal Opportunity Employer and promotes diversity within our workforce. We do not provide employment sponsorship.

Recent Accolades
  • Top Workplace - Richmond Region
  • Top USA Workplace
  • 2023 Top Award for Mid-Sized Companies
  • Doers Award

Minimum Qualifications

  • Required supervisory experience, including training, coaching, and employee development.
  • Experience in a fast-paced, high-volume production mailing environment, including printing, insertion, and shipping.
  • Proven ability to troubleshoot mechanical and technical issues with commercial inserter machines and high-volume printers.
  • Demonstrated capability to lead and motivate a team in a goal-oriented setting.
  • Familiarity with PDF manipulation and Microsoft Office applications, including Word, Outlook, Excel, and PowerPoint; experience with data entry and retrieval from database systems; and Internet research skills.
  • Strong organizational, analytical, and verbal and written communication skills.
  • Ability to manage multiple tasks with a keen attention to detail.
  • Knowledge of USPS rules and regulations related to correspondence management.
  • Experience operating pallet jacks and high-production inserter machines and printers.
  • Physical ability to frequently lift up to 50 lbs.

Additional Considerations

  • Preferred knowledge of Virginia Workers' Compensation Commission business processes.

Special Instructions

Confirmation of receipt will be provided upon successful submission of your application and/or résumé. Please refer to your account to check the status of your application for this position.



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