Workers’ Compensation Claims Specialist (FL, KY) REMOTE

About the role

Creative Risk Solutions (CRS) is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. We are seeking a Workers’ Compensation Claims Specialist to join our dynamic team.

Essential Responsibilities

• Receives, gathers, and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner.
• Investigates, evaluates, and resolves lost time Workers’ Compensation claims, including litigated claims.
• Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues.
• Enters and maintains accurate information on a computer system during the claim process, to include final settlement information.
• Generates checks for indemnity and medical payments daily.
• Develops and monitors consistency in procedural matters of claims handling process within CRS.
• Willingness to become licensed if required in jurisdiction where claims are handled.

Qualifications

• Education: High school diploma; college degree preferred.
• Technical designations encouraged, such as AIC and CPCU.
• Experience: 3-5 years claims experience with strong background in Workers’ Compensation claims handling. Prior experience handling Florida and Kentucky claims is required.
• Licensing: Active Florida and/or Kentucky Workers Compensation License required or the ability to acquire license within three months of hire.

Skills

• An ideal candidate will have proficient knowledge of Workers’ Compensation insurance coverage and claims processing procedures.
• The ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs.
• A strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements.
• The ability to prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience.

Benefits

• Core benefits: Health, dental, and vision insurance.
• Additional benefits: Paid parental leave, supportive new parent benefits, company-paid continuing education and tuition reimbursement, 401(k) profit sharing, generous time off practices, paid volunteer time off, and employee matching gifts to charities.
• Discretionary bonus opportunity.
• Annual merit increase and promotion opportunities.
• Consistent DE&I programs and diversity day time off.

Company Culture

We are committed to building a best-in-class culture through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members.