Claims Administrative Specialist

About the role

The Claims Administrative Specialist supports the entire workers’ compensation and liability claims lifecycle. You will ensure claim files are accurate, complete, and compliant by handling document management, records retrieval, forms processing, and regulatory reporting.

Key responsibilities

• Prepare and compile legal and claim‑related report packages, supporting litigation and defense referrals.
• Request, track, and retrieve medical records, police reports, and other external documentation, maintaining status logs.
• Generate and distribute state‑required forms, benefit notices, and other claim correspondence within jurisdictional timelines.
• Process claim‑related payments, set up recurring auto‑payments, and generate benefit notices.
• Prepare regulatory EDI transactions, monitor submission queues, and resolve errors or rejections.
• Manage high‑volume administrative tasks across multiple claim and document management systems, meeting SLA targets.

Required profile

• Strong attention to detail and ability to handle high‑volume, multi‑system tasks.
• Effective communication with internal teams and external stakeholders.
• Experience supporting workers’ compensation or liability claims preferred.
• Ability to prioritize, track, and meet strict deadlines.

Required skills

• Electronic Data Interchange (EDI)
• Claims management software