Claims Administrator

Claims Administrator

Are you a healthcare professional or nurse looking to transition out of direct patient care while still using your analytical skills, attention to detail, and documentation expertise?

We are seeking a Claims Administrator to support and oversee claims operations across workers' compensation claims. This role offers the opportunity to apply your experience reviewing documentation, identifying discrepancies, and ensuring complianceall within a structured, professional environment.

What You'll Do

• Manage and coordinate injury claims events involving workers' compensation including routing, documentation, and data entry
• Evaluate and assist with directing injury care
• Review documentation and claims information to ensure accuracy, completeness, and compliance with applicable regulations
• Track, trend, and analyze claims activity and related costs to support informed decision-making
• Analyze and update claim data as new information becomes available
• Assist in improving claims reporting procedures and workflows
• Collaborate with third-party administrators to evaluate claims and determine company liability
• Review billing information and process claims accurately, including third-party subrogation
• Assess documentation and determine claim validity based on available information
• Conduct thorough investigations by gathering relevant details from multiple sources
• Communicate with claimants, witnesses, and other stakeholders to obtain additional information
• Maintain accurate and compliant records in accordance with state and federal guidelines
• Evaluate expenses, reserves, and assist in claims resolution within authorized limits
• Partner with internal teams and external contacts to resolve claims efficiently
• Support reporting, trending, and statistical analysis for department insights
• Utilize claims management systems such as Origami, Claims Management System, and Risktrac
• Respond to after-hours incidents as needed

What You'll Bring

• Strong attention to detail and ability to review, interpret, and validate documentation
• Proven communication, organizational, and interpersonal skills
• Ability to manage sensitive information with confidentiality and professionalism
• Strong computer skills and ability to work within multiple systems
• Experience identifying discrepancies and ensuring accuracy in records or documentation
• Ability to anticipate needs, work independently, and meet deadlines
• Strong problem-solving and decision-making skills with the ability to assess complex situations
• Ability to collaborate with stakeholders at all levels and build effective working relationships
• Commitment to continuous improvement and process optimization
• Ability to function effectively both independently and within a team environment

Healthcare Experience

• Prior claims management or case management experience preferred OR
• Experience in a healthcare or clinical setting (e.g., nursing, medical support roles) with exposure to documentation review, compliance, or case coordination

What You'll Get

• 401(k) with company match (Traditional & Roth)
• Paid Holidays and PTO
• Medical, Dental, and Vision
• Flexible Spending Accounts
• Health Savings Account
• Accident Insurance
• Hospital Indemnity Insurance
• Critical Illness Insurance
• LifeLock Identity Theft Protection
• Employee Discounts
• Short-Term & Long-Term Disability
• For more benefit details click here!