Workers' Compensation Specialist II

Primary Duties

• Manage the day-to-day operations of the workers’ compensation program, ensuring prompt and efficient reporting and coordination of claims with insurance carriers and third-party administrators
• Cook with medical providers, employees, and insurance carriers to facilitate a smooth claims process and timely resolution
• Serve as the primary liaison between the company and external partners (insurance carriers, adjusters, and medical providers) regarding claim activity and status
• Maintain accurate records of all workers’ compensation claims and related documentation
• Ensure compliance with federal, state, and local workers’ compensation laws and regulations, as well as internal policies
• Provide guidance and training to management and employees on workers’ compensation procedures, reporting requirements, and expectations
• Investigate and report on incidents and accidents to determine root cause and support implementation of preventive measures
• Work closely with human resources and legal departments to support the handling of complex or litigated workers’ compensation cases
• Coordinate return-to-work programs and assist in developing modified duty plans for injured employees in collaboration with management and medical providers
• Monitor and analyze trends in workers’ compensation claims to identify areas for improvement and cost reduction opportunities
• Prepare and submit required reports to regulatory agencies as needed

Job Requirements

• Education and Experience Requirements: Associate’s degree in human resources, business administration, or related field; bachelor’s degree preferred
• Minimum of 3+ years of experience in workers’ compensation claims coordination or administration, preferably in a fully insured environment
• Bilingual (English/Spanish) preferred
• Knowledge, Skills, And Abilities: Working knowledge of workers’ compensation laws and regulations; familiarity with claim processes, insurance carrier interactions, and legal procedures; strong organizational, analytical, and communication skills; ability to exercise sound judgment and discretion when handling sensitive or complex situations; ability to manage multiple priorities in a high-volume environment; proficiency in Microsoft Office Suite and workers’ compensation or claims management systems; ability to handle sensitive and confidential information with discretion; Certification in Workers’ Compensation (e.g., CWCP) preferred

Essential Mental And Physical Functions

• Ability to sit and work at a computer for extended periods
• Occasional standing, walking, and lifting up to 20 lbs
• Use of fine motor skills for typing and document handling
• Ability to concentrate and make decisions in a dynamic work environment
• Regular interaction with employees, vendors, and regulatory agencies
• Work may require travel, including overnight stays