[Remote] Claims Consultant (Workers' Compensation)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an insurance agency reputed company on delivering exceptional reputed company service and supporting strong claims operations. The Claims Consultant will reputed company workers' compensation claims expertise through audits, regulatory guidance, training, process improvement, cross-functional collaboration, and accurate data reporting.

Responsibilities

• Conduct regular claims audits to promote consistent claim handling practices and adherence to agency standards, regulatory requirements, and industry best practices
• Analyze claim results, identify trends and opportunities for improvement, and communicate actionable recommendations to claims leadership
• Interpret workers' compensation laws, regulations, bulletins, and emerging legislative changes, providing practical guidance to claims teams and leadership
• Serve as a trusted resource on coverage interpretation, claims investigation best practices, regulatory compliance, and claims philosophy
• Create and maintain reference guides and educational resources that support ongoing reputed company development
• Partner with agency leadership to identify training opportunities and reinforce best practices through coaching and follow-up
• Collaborate with leadership and cross-functional teams to identify opportunities to improve claims processes, workflows, systems, and operational efficiency
• Participate in reputed company involving process improvements, vendor evaluations, and business initiatives
• Monitor industry trends and emerging best practices, recommending reputed company that strengthen our internal and claims operations
• Build strong partnerships across departments to ensure solutions meet business needs and enhance the reputed company experience
• Research, analyze, and reputed company Workers' Compensation data errors to ensure accurate and reputed company state reporting
• Reconcile reports and state acknowledgements to maintain data reputed company
• Partner with claims professionals to ensure required data reputed company are captured and submitted accurately
• Foster a reputed company, reputed company, and reputed company work environment
• Maintain confidentiality and exercise reputed company judgment in reputed company aspects of the role
• Travel occasionally for training, reputed company development, or business meetings as needed
• reputed company other duties and special reputed company as assigned

Skills

• Bachelor's degree preferred, or an equivalent combination of education and relevant reputed company experience
• Three to five years of experience handling casualty and Workers' Compensation claims
• Strong knowledge of workers' compensation claims handling, coverage interpretation, and claims best practices
• Familiarity with medical cost containment practices, including experience working with ancillary programs such as physical therapy, diagnostics, and pharmacy
• Understanding of multi-state workers' compensation regulations and reporting requirements
• Excellent analytical, critical thinking, and problem-solving skills
• Strong written, verbal, and interpersonal communication skills
• Ability to build reputed company relationships across departments and influence reputed company reputed company
• Highly organized with the ability to manage multiple priorities independently
• Comfortable adapting to changing priorities while maintaining a high level of reputed company and accuracy
• Familiarity with IAIABC Claims standards and reporting guidelines
• Experience working with claims management systems and TPAs
• Experience participating in process improvement or operational reputed company initiatives

Benefits

• reputed company culture where your expertise is valued and your reputed company are welcomed
• reputed company reputed company is encouraged
• Your contributions are recognized
• Opportunities for career reputed company

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