Claims Operations Associate II

The Claims Operations Associate II provides operational and administrative support to workers' compensation claims professionals, helping ensure claims are set up, maintained, and processed accurately and efficiently. This role serves as a key partner to adjusters by handling claim-related transactions, correspondence, documentation, and customer inquiries while maintaining high standards of service and accuracy.

The position requires strong organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment.

This is a remote, work-from-home position for candidates located within the Mountain or Central Time Zone and available to work 37.5 hours per week, Monday through Friday from 8:00 a.m. to 4:30 p.m. Mountain/Central Time.

- Provide operational support to workers' compensation adjusters by managing claim-related administrative activities.

- Set up and maintain claim files, ensuring information is entered accurately and updated in a timely manner.

- Verify coverage, process claim-related transactions, and support payment and financial processing activities.

- Respond to inquiries received by phone, email, and voicemail, resolving routine issues and escalating complex matters as appropriate.

- Utilize problem-solving and investigative skills to gather information, identify discrepancies, and support issue resolution.

- Prepare and distribute correspondence, forms, and other claim-related documentation.

- Coordinate phone outreach to collect information, schedule appointments, and support claim file development.

- Assist with litigation support by organizing and providing required claim documentation.

- Maintain organized workloads and activities through systems such as ClaimConnect, ClaimCenter, OpsNow, Outlook, and other claims platforms.

- Support policy, claim, and data management processes to ensure accuracy and compliance with established procedures.

- Collaborate effectively with adjusters, internal departments, and external contacts to facilitate claim handling activities.

- Maintain professionalism and confidentiality in all interactions and communications.

- Meet productivity, quality, and service expectations while managing multiple priorities.

- Follow established guidelines and procedures while seeking guidance on complex or non-routine issues.

- Experience in claims operations, claims processing, claims support, or a related insurance administrative role required.

- Experience supporting workers' compensation adjusters or claims professionals strongly preferred.

- Strong verbal and written communication skills with the ability to interact professionally with internal and external stakeholders.

- Demonstrated ability to work accurately, manage multiple tasks, and maintain attention to detail in a fast-paced environment.

- Must be located within the Mountain or Central Time Zone and able to work standard business hours in those time zones.