Workers Compensation Claims Specialist
About the role
The organization operates in the hearing healthcare industry, addressing the challenge of making hearing health care accessible and affordable. It is a leading provider of hearing health care benefits with a national network of over 7,000 clinics, serving more than 50 million individuals across the United States. The organization supports comprehensive hearing well-being by bridging retail and insurance industries across Canada, Latin America, and the U.S., impacting a large population and employing diverse, innovative talent. The WORKERS COMPENSATION CLAIMS SPECIALIST role supports the workers' compensation business by managing hearing healthcare services coordination and case activities from referral to follow-up. This position serves as a key contact for injured workers, claims professionals, healthcare providers, and client partners, ensuring cases progress accurately and efficiently. The specialist's work directly contributes to timely access to care and effective case management, impacting the quality and efficiency of the organization's workers' compensation services.
Responsibilities
- Serve as primary contact for claimants, claims adjusters, providers, and partners.
- Coordinate referrals, appointments, and next steps for hearing healthcare services.
- Manage communications via phone, email, and internal systems, keeping stakeholders informed.
- Assist customers in understanding services, processes, and overcoming barriers.
- Provide timely updates and follow-up throughout case lifecycles.
- Monitor cases for outstanding items and take ownership of follow-up.
- Coordinate communications among all parties to keep cases progressing.
- Maintain accurate case documentation ensuring compliance and quality.
- Manage multiple cases and priorities with attention to detail.
- Support audits, reporting, escalated case resolution, and operational initiatives.
- Identify and suggest process improvements for efficiency and customer experience.
- Participate in training to develop knowledge of hearing healthcare and workers' compensation.
- Collaborate internally to support departmental and business goals.
Requirements
- High school diploma or equivalent.
- 1-2 years of experience in customer service, healthcare administration, insurance, claims support, case coordination, scheduling, benefits administration, or related fields.
- Strong organizational skills to handle multiple priorities and deadlines.
- Attention to detail and accuracy in documentation.
- Clear and professional verbal and written communication skills.
- Ability to work independently and follow through on responsibilities.
- Proficiency in Microsoft Outlook, Word, Excel, and quick adaptability to new systems.
- Ability to build effective working relationships with various stakeholders.
Qualifications
- Experience in workers' compensation, insurance, claims support, healthcare administration, case coordination, scheduling, benefits administration, or contact centers.
- Familiarity with CRM, case management, customer service platforms, Five9 or similar contact center technology.
- Experience with ERP, practice management, point-of-sale, provider or client portals.
- Strong problem-solving, prioritization, and organizational skills in fast-paced environments.
Benefits
- Medical, Dental, and Vision insurance.
- 401(k) with company match.
- Family hearing aid benefits.
- Tuition reimbursement.
- Generous vacation, sick leave, paid holidays, paid volunteer time off.
- Parental leave and bereavement.
- Access to wellness resources and Employee Assistance Program.
- Career development opportunities including training and online learning platforms.
Pay
The anticipated pay range is $23.00 to $25.25 per hour based on qualifications. Eligibility to participate in a quarterly incentive program. This position may be onsite or remote within designated states.