Associate Claims Specialist

This is a Fully Remote Job About Our Client:This organization operates within the workers' compensation insurance sector, focusing on managing claims related to medical-only and limited lost time injuries. They address the challenge of minimizing losses on claims while ensuring compliance with jurisdictional requirements and providing effective claims management. About the Opportunity:The ASSOCIATE CLAIMS SPECIALIST role is responsible for proactively managing medical-only, limited lost time, and permanent total claims to minimize financial losses and ensure compliance with relevant regulations. This position plays a key part in maintaining customer service quality and supports the claims process by handling payments, authorizing treatments, and coordinating with medical providers. Responsibilities:Contact accounts on First Notices of Loss to gather necessary information for file setupProcess payments, answer calls, and authorize treatment for Medical Only claimsComplete initial contacts within 24 hours and establish follow-up schedulesAssess appropriateness and causal relation of treatments to compensable injuriesRedirect treatment to network physicians when appropriateRefer claims with subrogation or permanency potential to supervisorEnsure compliance with jurisdictional requirements, including timely form filingMaintain knowledge of jurisdictional requirements and obtain/maintain necessary state adjusting licensesAdminister benefits for Permanent Total or Death cases, monitoring for status changes and cost increasesUphold the organization's Code of Business Conduct and Ethics and comply with relevant policies, procedures, and laws Requirements:High school diploma or equivalentOne or more years of Workers Compensation claims handling experienceRequired license or ability to obtain license within 90 days of employment in mandated statesFamiliarity with medical terminologyAbility to work independently, multitask, make decisions, and maintain attention to detailStrong organizational skillsExcellent verbal and written communication skillsProficiency in MS Excel and MS WordAbility to work remotely Pay Range and Compensation Package:Target Salary - $58,000 - $73,000 Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.