Careers

Worker’s Compensation Claims Specialist III, California

If you enjoy providing excellent customer service and have at least five years’ experience adjudicating workers’ compensation claims, this could be a fit for you! Do you desire to lead and share knowledge with other claims specialists on the team? Have you ever worked for a company whose motto is “Work hard, play hard, and love who you do it with”; who’s passionate about challenging you to think differently; and who cares about YOU the employee?

Creative Risk Solutions, a subsidiary company of Holmes Murphy, is a progressive, fun fast-paced Third-Party Claims Administrator. At Creative Risk Solutions, our employees play to their strengths and contribute to who we are and want to be. We like to think of ourselves as pretty irresistible. If that intrigues you and you think you’re a perfect fit to join our team as a Workers’ Compensation Claims Specialist III, keep reading!

Duties:

  • 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, 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.
  • Compiles and interprets Workers’ compensation reports on designated accounts, as requested.
  • Participates in claim reviews when requested by agency partners or insured’s. These could be in person or by phone.
  • Ability to adjudicate lost time claims in Iowa Jurisdictions claims.
  • 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, preferably California.
  • Knowledge, Skills, and Abilities:
  • Knowledge of Workers’ Compensation insurance coverage and the ability to apply that knowledge in the performance of the job duties.
  • Skillful knowledge of claims processing procedures.
  • Ability to work with persons under adverse or highly emotional conditions.
  • Knowledge of organizational methods and the ability to manage multiple tasks/duties simultaneously.
  • Ability to work daily and extended hours, as necessary.
  • Ability to maintain confidentiality.
  • Ability to act in a professional and courteous manner.
  • Ability to learn various software programs.

Qualifications:

  • A high school diploma or GED equivalent required, college degree preferred
  • Minimum of five years’ experience workers’ compensation claims, including litigated claims. Prior agency or carrier experience preferred.

If you’re ready for a new and exciting opportunity to work for an amazing company and you think you have what it takes to be a Workers’ Compensation Claims Specialist for Creative Risk Solutions, apply today!

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Worker’s Compensation Claims Specialist III, California