Spanish-Speaking Workers Compensation Claims Specialist

About the role

This hybrid day-shift specialist role handles workers compensation insurance claims while delivering high-quality customer service in Spanish and English. The specialist manages claims from start to finish, supports injured workers and employer clients, and ensures accurate documentation and resolution in line with regulatory and company standards.

Key responsibilities

• Manage claims from intake to closure, capturing incident details and setting them up accurately in internal systems.
• Handle inbound and outbound calls in Spanish and English, explaining claim status, benefits and next steps.
• Check claim documents such as injury reports, medical notes and wage statements for completeness and consistency.
• Coordinate with medical providers and employers to keep the claim file complete and up to date.
• Explain benefits, coverage limits and procedural steps in accessible language.
• Monitor claim progress against service level targets and escalate complex cases to senior specialists.
• Document every interaction and decision point in claim systems and share insights with colleagues.
• Stay current with policy updates and use digital tools and knowledge resources efficiently.

Required profile

• Two to three years of customer service experience handling complex inquiries.
• Hands-on exposure to workers compensation claims, including intake, investigation, documentation and benefit explanation.
• Fluent Spanish and English, reading, writing and speaking.
• Basic knowledge of workers compensation regulations, timelines and claimant protections.
• Resilience and emotional maturity when dealing with injured workers and stressed employers.

Required skills

• Analytical skills to spot missing information, inconsistencies and potential risks.
• Confident use of case management or claims systems.
• Preferred: Workers Compensation Claims Professional certification or equivalent customer service training.