Claims Professional

About the role

We are looking for a Claims Specialist to support workplace injury case coordination for a service organization in Los Angeles, California. This contract-to-permanent opportunity is ideal for someone with experience handling workers’ compensation documentation, medical status tracking, and communication with supervisors and adjusters. The person in this role will help maintain accurate claim records, promote timely follow-up, and assist with return-to-work efforts for employees recovering from job-related injuries.

Responsibilities

• Manage an assigned group of modified duty and lost time workers’ compensation claims from intake through closure support.
• Review work-related medical documentation, record key details in the system, and route records to the appropriate insurance adjuster.
• Notify supervisors of initial medical findings, work status updates, and any changes that affect employee availability.
• Coordinate follow-up activity by scheduling reminders for medical appointments and obtaining documented status updates within 24 hours of each visit.
• Share appointment outcomes promptly with both the insurance adjuster and internal leadership to keep claim activity current.
• Support early return-to-work efforts by working with management and affected employees to align contract work options with medical restrictions.
• Track lost work time and modified duty assignments to ensure claim records remain complete and accurate.
• Maintain ongoing communication with insurance adjusters at regular intervals until each claim is resolved, and perform routine audits of claim data for accuracy and completeness.

Requirements

• At least 2 years of experience in claims administration, workers’ compensation support, or a related HR or leave management role.
• Working knowledge of workers’ compensation processes, including medical documentation handling and claim follow-up practices.
• Ability to interpret and document medical work status information with a high degree of accuracy.
• Strong organizational skills with the ability to manage deadlines, appointment tracking, and multiple active cases.
• Clear written and verbal communication skills for coordinating with employees, supervisors, managers, and insurance adjusters.
• Proficiency with computer-based recordkeeping systems and data entry in a fast-paced environment.
• Detail-oriented approach with the ability to audit records and identify missing or inconsistent claim information.