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We are looking for a Workers Compensation - Claims Specialist to join our team on a contract basis in Saint Louis, Missouri. This role involves managing workers' compensation claims while ensuring compliance with legal and organizational standards. Ideal candidates should possess strong analytical skills and a deep understanding of claims processes to effectively handle cases and liaise with relevant stakeholders.
Job Responsibility:
Serve as a point of contact for employees, gathering detailed information about injuries and educating them on the injury management process
Organize, analyze, and maintain comprehensive files for all work-related injuries, ensuring accurate documentation of claims
Manage medical-only claims and maintain a detailed diary of case progress
Coordinate return-to-work programs and collaborate with business partners to facilitate modified duty arrangements
Conduct annual reviews and updates of wall posters in stores, detailing medical treatment facility locations
Facilitate claim reviews and collaborate with external partners on investigations and settlements
Analyze data trends to create precise reports and recommend settlements during claim review meetings
Ensure proper reporting of claims, including questionable cases, and assist in determining coverage lines within the workers' compensation program
Preserve evidence such as video and documentation related to claims
Communicate with insurance carriers, injured employees, and other stakeholders to ensure timely submission of necessary forms and records
Requirements:
High school diploma required
two years of college education preferred
Minimum of 1 to 3 years of experience in insurance, preferably workers' compensation or claims handling
General knowledge of insurance programs and workers' compensation claims processes
Proficiency in Microsoft Excel, Word, Outlook, and claims management systems such as Origami and Travelers
Strong analytical skills with the ability to interpret data, identify trends, and prepare detailed reports
Familiarity with collective bargaining agreements and legal exposure related to workers' compensation
Experience in evidence preservation, including handling video and document storage
Knowledge of civil litigation, discovery, trial preparation, and case management software