WORKERS' COMPENSATION CLAIMS SPECIALIST

Job Description

Job Description

Responsibilities

Healthcare Services Group (HCSG) is seeking a Workers’ Compensation Claims Specialist to join our growing Corporate Team.

Role

Workers’ Compensation Claims Specialist

Department

Risk Management — Workers' Compensation Group

Reporting Line

Reports directly to the WC Claim Manager

Primary Goal

Protect organizational integrity through effective risk mitigation & claims liaison

What We Do & Why It Matters

Our Risk Management team keeps Healthcare Services Group (HCSG) strong, steady, and trusted. We tackle risks head-on, plan ahead for what’s coming, and build solid relationships across the company. We focus on practical, cost-effective solutions that respect everyone involved while staying true to our values.

Key Responsibilities

As a Workers' Compensation Claims Specialist, you will support the department by serving as a key operational liaison between HCSG and external claims organizations, including Workers' Compensation Carriers and Third-Party Administrators (TPAs).

 

• Claims Organization Liaison: Operating as a primary link between HCSG and external claims vendors (WC Carriers and TPAs) to ensure timely, effective claims handling.
• Incident Review & Outcome Optimization: Reviewing workplace incidents and internal/external reporting to drive optimal loss and expense outcomes.
• Tracking & Compliance: Maintaining incident tracking systems for thorough follow-up while ensuring full compliance with HCSG's incident reporting policies.
• Medical Case Management: Managing and coordinating HCSG's medical case management vendor, designating vendor involvement at the initial reporting stage.
• Claims Oversight: Providing workers' compensation oversight for non-litigated cases within an assigned territory and facilitating appropriate claim closures.
• Worker Outreach & Return-to-Work: Managing the injured worker outreach program and ensuring Field Operations adhere to HCSG's Return-to-Work policies and procedures.
• Structured Progress: Every team member is expected to set stretch goals to expand their capabilities. Goal progress is reviewed monthly to promote ongoing growth and provide transparent, predictable performance evaluations.

Candidate Profile & Qualifications

• Core Attributes: Dependable, proactive, highly attentive to detail, and capable of working independently with minimal supervision.
• Communication: Exceptional verbal and written communication skills paired with a consistent professional demeanor.
• Technical Proficiency: Technical proficiency in Microsoft Office applications and Gmail.

 

Team Culture & Environment

• Supportive & Realistic: Risk Management is a 12-person department with a focused 7-member Workers' Compensation team. The team sets high standards and takes its work seriously, while remaining supportive, realistic, and approachable.
• Balanced Social Atmosphere: The team enjoys a friendly, sociable culture—hosting events like potlucks, team lunches, and seasonal cookie swaps throughout the year—while fully respecting individual boundaries and personal comfort levels.

 

 

QUALIFICATIONS :

• Mininum 4 years experience in a administrative or customer care support role. Previous Workers Compensation experience a plus.
• Technical proficiency (MS Office and Gmail) required
• Dependable, proactive, attentive to detail, and able to work independently with minimal supervision
• Exceptional communication skills and professional demeanor, Spanish speaking a plus