The Claims Coordinator is responsible for investigating and determining public employees’ eligibility for workers’ compensation benefits and authorizes payments of those benefits. This includes review and evaluation of medical records, interviewing injured employees and witnesses, determining whether claims meet the statutory and case law requirements for compensability, authorizing payments, identifying appropriate cases for settlement, and pursuing subrogation. Testifying at workers’ compensation administrative hearings and civil trials involving subrogation may occasionally be required. In-state travel on occasion may be required.
This position requires on-site employment with no remote or hybrid options available.
Job Responsibilities and Expected Results
Reviews claims documentation submitted, interviews and documents statements of claimants, supervisors and witnesses, and obtains medical information.
Determines eligibility for workers’ compensation benefits and notifies all parties of determination.
Files notification of acceptance or denial of lost-time claims with the Arkansas Workers’ Compensation Commission and maintains and reviews case files.
Initiates payment of benefits and attorneys’ fees
Review and pay bills to ensure they are authorized, reasonable and related to the workers’ compensation injury.
Negotiates settlements in appropriate workers’ compensation claims.
Assists legal staff with litigation by providing attorneys with all claim information and testifying at hearings as necessary.
Identifies and pursues possible subrogation claims.
Performs other duties as assigned.
Job Series: Program Operations – Claims Administration
Classification: Claims Coordinator
Class Code: PCA01P
Pay Grade: SGS07
Salary Range: $57,351 – $84,879
The Claims Coordinator is responsible for managing and organizing the claims process to ensure accurate, efficient, and timely resolution of insurance claims. This role involves serving as a central point of communication between claimants, insurance providers, and internal teams, as well as maintaining records, monitoring claim statuses, and facilitating resolutions. The Claims Coordinator plays a vital role in streamlining operations and ensuring customer satisfaction by ensuring claims are handled in a professional and compliant manner.
Coordinate the entire claims process, from initial reporting to resolution, ensuring efficiency and accuracy.
Serve as the primary liaison between claimants, insurance adjusters, healthcare providers, legal teams, and internal personnel.
Review and verify claim documentation for completeness and compliance with policy terms.
Monitor claim statuses and maintain up-to-date records in claims management systems.
Investigate claim details, identify discrepancies, and resolve issues in collaboration with a variety of assorted personnel.
Communicate updates and outcomes of claims to relevant parties in a clear and timely manner.
Assist in developing and implementing process improvements for better claims handling.
Ensure adherence to agency policies, industry standards, and regulatory requirements.
Prepare reports and summaries on claims data and trends for management review.
Strong organizational and multitasking abilities.
Excellent verbal and written communication skills for interacting with a variety of assorted personnel.
Attention to detail and the ability to analyze and resolve discrepancies.
Knowledge of insurance policies and regulations is advantageous.
A customer-focused and problem-solving mindset is essential.
Bachelor’s degree in business administration, insurance, healthcare administration, or a related field.
Minimum of 4 years of experience in claims coordination, claims management, customer service, or related fields.
Satisfaction of the minimum qualifications, including years of experience and service, does not entitle employees to automatic progression within the job series. Promotion to the next classification level is at the discretion of the department and the Office of Personnel Management, taking into consideration the employee’s demonstrated skills, competencies, performance, workload responsibilities, and organizational needs.
N/A
OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.
When you work for the State of Arkansas, you have the unique opportunity to make a real difference in the lives of others through the delivery of critical services. Whether improving the lives of others through workforce development, critical infrastructure repair, foster care placement, emergency response, blockchain technology, or forestry preservation, state employees add significant value to the lives of all Arkansans.
