Claims Technical Specialist

Location: Bloomington, Minnesota (Hybrid - Approx. 1 day/week in office) | Full-Time

Pay: $90,141 to $126,198

Ranked #8 Top Workplace - Midsize Employer, MN

As a Claims Technical Specialist
, you will serve as a trusted technical expert and strategic partner to the Claims organization. In this role, you’ll provide advanced guidance on complex workers’ compensation claims, ensure compliance with multi-jurisdictional regulatory and reporting requirements, and support the integrity of claims financials and systems. You’ll also play a key role in claims technology enhancements, audits, and training—helping drive consistency, quality, and continuous improvement across claims operations.

• Serve as a technical resource for claims staff by providing expert guidance on claims management practices, financial reconciliation, and resolution of complex or high-exposure claims.
• Conduct technical claim reviews and audits to ensure compliance with federal, state, contractual, reinsurance, and reporting requirements, including prompt action standards and quality benchmarks.
• Oversee and support EDI, Medicare (CMS), NCCI, and reinsurance reporting, partnering closely with Information Services and Finance to resolve data, system, and financial issues.
• Collaborate with Information Services to analyze claims technology needs, test and implement system enhancements, and validate system changes to ensure data integrity.
• Support claims financial accuracy through audit assistance, reconciliation efforts, and collaboration on recoveries and accounting issues.
• Develop, document, and maintain claims procedures, best practices, and internal resources to promote consistency and operational excellence.
• Provide training, coaching, and mentoring to claims staff, and contribute to training development, delivery, and claims hiring processes.
• Monitor emerging legal, regulatory, and industry trends in workers’ compensation and support readiness for expansion into new jurisdictions.

Education and Experience

• Bachelor’s degree or an equivalent combination of education and relevant work experience
• Seven or more years of experience handling workers’ compensation claims or similar roles in the property and casualty industry; multi jurisdictional experience preferred
• Experience in technical claims support, compliance, auditing, financial reconciliation, claims systems analysis, or similar operational support functions preferred
• Familiarity with IAIABC Claims EDI Reporting Standards preferred
• Experience with reporting or analytics tools such as Cognos, Tableau, or Power BI preferred
• Professional insurance designations related to area of expertise preferred
• Advanced knowledge of workers’ compensation claims handling and applicable laws and regulations

• Strong analytical, research, and problem solving skills with the ability to interpret data and support sound decisions
• Strong technical aptitude with claims systems, data, reporting tools, and Microsoft Office applications such as Excel and Word
• Excellent verbal, written, and presentation skills with the ability to collaborate, coach, and support employee development
• Ability to manage difficult conversations, maintain confidentiality, and exercise sound judgment and discretion
• Highly organized with the ability to manage multiple priorities in a fast paced environment while maintaining strong customer service and partnership across teams
• Ability to work onsite in the office when needed

We want your work life to feel balanced, rewarding, and supported. Here are just a few of the benefits SFM offers:

• Comprehensive medical, dental, and vision coverage (plus HSA/FSA options).
• Significant Cash Benefit if You Opt Out of Our Health Plan
• Flexible hybrid work environment.
• 401(k) with both Traditional and Roth options + company match.
• Contributions toward student loan repayment.
• Generous PTO, 9 paid holidays, and paid parental leave.
• Monthly home internet allowance.
• Free life insurance, short-term & long-term disability coverage.
• Incentive bonus opportunities.
• Discounts on gyms, fitness apps, and wellness programs.

SFM is the…