Claims Specialist

The Opportunity

You'll join a collaborative claims team responsible for reviewing and managing workers' compensation claims from initial submission through resolution. The role combines administrative accuracy, customer service, and proactive case management.

What You'll Be Doing

• Claims Review & Processing:
  • Review and process new workers' compensation claims accurately and efficiently
  • Gather and verify claim details from employers, injured workers and medical providers
  • Maintain accurate records and update claims systems with required information
  • Collect and review medical documentation to support claim decisions and updates
  • Ensure claims meet internal quality standards and regulatory requirements
• Customer Communication:
  • Manage incoming and outgoing calls with employers, healthcare providers and injured workers
  • Provide clear, professional support throughout the claims process
  • Document conversations, updates and next steps accurately
• Case Management & Follow-Up:
  • Proactively monitor claims progress and complete required follow-ups
  • Support early return-to-work initiatives where appropriate
  • Identify cases requiring additional support or specialist involvement
  • Collaborate with internal teams to ensure effective claim resolution
• Team Support & Quality:
  • Work closely with colleagues to achieve team performance goals
  • Maintain high standards of accuracy, confidentiality and customer service
  • Support continuous improvement across claims processes
  • Meet productivity and quality expectations

What They're Looking For

• High school diploma or equivalent
• Previous customer service, administration or claims experience preferred
• Strong attention to detail and ability to manage multiple priorities
• Excellent communication skills, both written and verbal
• Comfortable handling confidential and sensitive information
• Strong organisational and problem-solving skills
• Able to work efficiently in a high-volume environment
• Proficiency with Microsoft Office applications including Word, Excel and Outlook
• Able to type 50–60 words per minute

Nice to Have

• Previous workers' compensation or insurance experience
• Familiarity with medical terminology
• Experience working with claims management systems
• Background in healthcare administration or case management