Workers' Compensation Claims Specialist (REMOTE - ME, CT, NJ)

About the role

Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our 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 Maine, Connecticut, and New Jersey claims is required.
• Licensing: Active Maine, Connecticut, and/or New Jersey 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

• Paid Parental Leave and supportive New Parent Benefits
• Company paid continuing Education & Tuition Reimbursement
• 401k Profit Sharing
• Generous time off practices in addition to paid holidays
• Paid Volunteer time off and employee matching gifts to charities
• Consistent merit increase and promotion opportunities
• Discretionary bonus opportunity

Pay

The salary range for this role is $57,500– $98,900. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications.

Schedule

Details on the schedule will be provided upon hire.