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Robert Half Logo Robert Half · Insurance

Claims Specialist

United States, Los Angeles · Job Posted January 22, 2026
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Job Description

We are looking for an experienced Claims Specialist to join our team in Los Angeles, California. In this role, you will focus on managing workers' compensation claims while ensuring compliance with medical management processes and communication protocols. This is a Contract to Permanent position, offering a dynamic opportunity to contribute to a service-driven organization.

Job Responsibility

  • Manage a portfolio of modified duty and lost time claims, ensuring accurate and timely updates
  • Coordinate the forwarding of work-related injury medical records to insurance adjusters
  • Input medical record data into the system and communicate initial diagnoses and work statuses to supervisors
  • Assist injured employees and hospital managers in implementing early return-to-work programs
  • Schedule follow-up medical appointments and ensure documented medical statuses are secured within 24 hours of each appointment
  • Relay outcomes of medical appointments to supervisors and insurance adjusters within 24 hours of receipt
  • Monitor lost time and modified work statuses in the system, maintaining accurate tracking
  • Maintain regular communication with insurance adjusters every 60 days until claims are resolved
  • Conduct audits of claim data and related information to ensure accuracy and compliance
  • Perform monthly audits on organization-related data to support operational efficiency

Requirements

  • Minimum of 2 years of experience managing workers' compensation claims
  • Strong knowledge of medical management processes and workers' compensation regulations
  • Excellent organizational skills with the ability to track and process claim information efficiently
  • Effective communication skills for liaising with supervisors, employees, and insurance adjusters
  • Ability to work collaboratively with hospital managers and injured employees
  • Proficiency in computer systems for inputting and auditing claim data
  • Detail-oriented approach to managing deadlines and ensuring compliance
  • Commitment to maintaining accurate records and providing timely updates

What we offer

  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan
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