Canton - WC Claims Specialist - PN

Overview

Job Description - Canton - WC Claims Specialist - PN:  (260000BG)

Location:

Canton Service Office, 339 East Maple Street Suite 200 North Canton , United States of America- OHIO
- Stark County-North Canton. Primary

Location:

United States of America-OHIO-Stark County-North Canton.

Schedule:

Full-time.

Work Hours:

40. Union: OCSEA. Compensation: $25.77 - $33.52.

Organization:
Workers’ Compensation

Agency Contact:
Mia Truss-Davis - HCM Sr. Analyst:
Mia.

T.1o.gov

Unposting Date:
Jan 22, 2026, 4:59:00 AM

Primary Job Skill:
Claims Examination

Technical

Skills:

Claims Examination, Customer Service

Professional

Skills:

Attention to Detail, Critical Thinking, Teamwork, Time Management, Written Communication

• Manages a caseload of Workers’ Compensation claims:
  Communicates, coordinates & collaborates with internal & external stakeholders (e.g., Disability Management Coordinator, Medical Service Specialist, Managed Care Organization, Employer Management team, Safety & Hygiene, injured workers, employers, Third Party Administrators, rehabilitation personnel) to set return to work expectations.
• Performs initial/subsequent claims investigation & determination within prescribed time frames: contacts parties involved in claim process; completes investigation during initial claim development to determine information pertinent to management of claim (e.g., jurisdiction, coverage, causality, compensability, claim data accuracy, current work status of claimant, job description, salary continuation, physical demands of job, work history of claimant).
• Processes various types of compensation (Temporary Total, Wage Loss, Permanent Partial and Percentage of Permanent Partial, Living Maintenance, Lump Sum Advancement); addresses subsequent requests by parties to claim via due process notification, investigation, and referrals to the Industrial Commission of Ohio.
• Responds to customer inquiries and follows Ohio Revised Code and BWC policies and procedures.
• Communicates with legal representatives, employers, claimants, etc.

36 months’ experience in a private insurance organization as claims representative or equivalent position; successful completion of one typing course or demonstrate ability to type 35 words per minute. Or completion of undergraduate core coursework in business, humanities, social & behavioral science, education or related field with typing ability. Or 24 months’ experience as Workers’ Compensation Claims Assistant (codes 16720) or 24 months’ experience as BWC Customer Service Representative (code 64451) or as BWC Employer Service Representative (code 63521).

Or 12 months’ experience as Workers’ Compensation Medical Claims Specialist (code 16721). Or any combination totaling at least 36 months in private insurance claims roles and/or related BWC positions.

Note:

Classification may require proficiency demonstration to determine minimum qualifications. Job

Skills:

Claims Examination.

Major Worker Characteristics:

Knowledge: workers’ compensation laws, policies & procedures; eligibility criteria & processing;
English grammar & spelling; oral & written business communication; public relations; basic mathematics; interviewing techniques; internet navigation; medical terminology; medical diagnosis coding;
Industrial Commission processes; claims reserving.

Skill in: PC operation; typing;
Microsoft Office; BWC software (e.g., Workers’ Compensation Claims Management System, Intrafin, FMS fraud system); office equipment; communication; internet use.

Ability to: define problems, collect data, establish facts, draw conclusions; read and understand medical references; manage data; respond to sensitive inquiries; make referrals; diffuse situations; present information; work in a team; use ICD coding; generate business correspondence; read compensation screens; interpret Cognos reports.

EEO & ADA Statement: The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal and state law and executive…