Claims Care Advocate (Remote)

Overview

This role provides essential administrative and workflow support within the Claims Department. The Claims Care Advocate partners with Claims Operations, Subrogation and Technical Services, and Nurse Case Management, and serves as a key point of contact for policyholders and external partners.

Responsibilities

• Provide comprehensive administrative and workflow support across Claims Operations, Subrogation, Litigation Technical Services, and Nurse Case Management.
• Act as a primary point of contact for internal and external inquiries, delivering timely, accurate, and professional responses via phone, email, fax, chat, and web portals.
• Manage and process requests for claim-related documentation, including wage statements, earnings affidavits, medical records, offer letters, rating requests, and records requests through third-party vendors.
• Index, process, and maintain claim files to ensure required information is accurately captured for efficient claims review and regulatory compliance.
• Support claim intake activities by gathering necessary information, identifying initial compensability considerations, and documenting claims in accordance with established procedures.
• Coordinate and process time-sensitive external requests, including Division of Workers’ Compensation forms, OSHA reports, police reports, conservation records, death certificates, and driver’s license suspensions.
• Prepare and distribute claim files to attorneys, subrogation adjusters, and other partners as needed.
• Manage activities within ClaimCenter queues and ImageRight to ensure timely document handling and task completion.
• Coordinate logistics for injured workers and claims staff, including IME scheduling, follow-up appointments, transportation arrangements, and hotel reservations.
• Partner with external vendors such as CorVel, OneCall, Metro Reporting, and HomeLink to support claims operations.
• Manage certified mailings and collections-related activities, including monthly expense reconciliation.
• Promote services to policyholders, producers, medical providers, injured workers, and attorneys when appropriate.
• Follow the organization’s vision, mission, and values in all interactions and work activities.

Qualifications

Education

• High school diploma or equivalent required
• Bachelor’s degree preferred

Licenses

• Valid driver’s license required

Experience

• One or more years of experience in a professional office environment
• Prior exposure to Workers’ Compensation or a similar industry is preferred

Compensation & Benefits

• Health Plans: Medical, Dental, and Vision (includes fertility benefits, fully paid preventative care, and adult orthodontia)
• Annual Performance Based Bonus
• Employer-Paid Life and Disability Benefits: Life Insurance (3x base salary), AD&D, Short and Long-term Disability
• Wellness and Recognition Program: Employer-paid incentives for employees and spouses
• Flexible Spending Account and Dependent Care options
• Health Savings Account: Generous employer contribution
• Time Away from Work: Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave
• Employee Assistance Programs
• 401k Retirement Plan: Employer match and profit sharing
• Adoption Assistance and Tuition Assistance

Notice Regarding Use of Artificial Intelligence

Artificial intelligence (AI) tools may be used to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment, in compliance with applicable laws.