Claims Management Specialist

SWBC is seeking a talented individual to manage workers' compensation claims from injury reporting through claim closure. This role works closely with customers, injured employees, insurance carriers, claim adjusters, HR, and payroll to facilitate efficient claim handling, support return-to-work efforts, and provide a high level of customer service.

Why you'll love this role:

In this position, you will play a critical role in supporting clients and injured employees throughout the workers' compensation process. You will build strong relationships with clients, collaborate with insurance carriers and claim adjusters, and help drive positive claim outcomes through proactive claim management, communication, and customer service. Your efforts will directly contribute to client satisfaction, risk management, and employee well-being.

Essential duties include the following:

• Coordinates and manages workers' compensation claims from initial injury reporting through resolution and closure.
• Serves as the primary liaison between client companies, injured employees, insurance carriers, claim adjusters, medical providers, payroll, HR, and internal stakeholders.
• Educates clients and injured employees on workers' compensation procedures, reporting requirements, return-to-work programs, available resources, and their responsibilities throughout the claims process.
• Provides exceptional customer service and guidance while ensuring all parties understand required protocols, next steps, and claim-related obligations.
• Coordinates claim documentation, wage reporting, claim-related communications, and return-to-work activities to support positive claim outcomes.
• Monitors claim progress and collaborates with carriers, adjusters, employers, and medical providers to facilitate efficient claim resolution.
• Reviews claim status with carriers and adjusters, participates in client claim reviews, and assists with the collection and analysis of claims history, loss trends, and risk-related information.
• Maintains accurate claim records, documentation, and reporting.
• Maintain necessary certifications.
• Performs all other duties as assigned.

Serious candidates will possess the minimum qualifications:

• Bachelor’s degree in Human Resources, Risk Management and Insurance, related field of study from an accredited four-year college or university preferred.
• Minimum of four (4) years of experience in claims management or related field required.
• Working knowledge of workers' compensation claims processes, return-to-work programs, and claim resolution practices.
• Knowledge of OSHA regulations, workplace safety practices, and accident prevention programs preferred.
• Bilingual (Spanish) language ability is required.
• Strong organizational skills with the ability to manage multiple priorities, meet deadlines, and maintain attention to detail.
• Ability to analyze information, solve problems, and exercise sound judgment.
• Able to communicate in writing clearly and concisely.
• Strong customer service and relationship management skills with the ability to effectively interact with clients, injured employees, carriers, and internal stakeholders.
• Able to sit and stand for long periods of time performing sedentary activities.

SWBC offers*:

• Competitive overall compensation package
• Work/Life balance
• Employee engagement activities and recognition awards
• Years of Service awards
• Career enhancement and growth opportunities
• Leadership Academy and Mentor Program
• Continuing education and career certifications
• Variety of healthcare coverage options
• Traditional and Roth 401(k) retirement plans
• Lucrative Wellness Program

*Based upon employee eligibility

Additional Information:

SWBC is a Substance-Free Workplace and requires pre-employment drug testing.

Please note, SWBC does not hire tobacco users as allowed by law.

To learn more about SWBC, visit our website at www.SWBC.com. If interested, please click the appropriate apply button.

Originally posted on Himalayas