Claims Specialist

Job Title: Claims Specialist

Location: Fully Remote

Pay Range: $30 - $50 an hour

A highly reputable organization is looking for a NC Licensed Property & Casualty Insurance adjuster to join their team as a Claims Specialist! This role includes a large range of duties including but not limited to managing a high-volume portfolio of workers compensation claims, ensuring timely, accurate, and fair handling from initial report through closure. This temporary role focuses on investigating new claims, determining compensability under the Workers Compensation Act, coordinating appropriate medical treatment and workplace accommodations, and supporting injured employees throughout the claims process. The position offers an opportunity to apply deep workers compensation expertise within a large and complex organization while working fully remotely.

Responsibilities:

• Manage approximately 6075 active workers compensation claims at any given time, maintaining accurate and up-to-date documentation for each file.
• Receive approximately 04 new workers compensation claims per day and balance new intake with ongoing efforts to close existing claims efficiently.
• Investigate new claims to determine coverage under the Workers Compensation Act, including gathering relevant information and making clear recommendations for acceptance or denial.
• Contact injured employees and their managers within one business day of receiving a claim to obtain key details, explain the claims process, and establish expectations.
• Obtain statements from injured employees and other involved parties, gather and review available medical records, and assess claim compensability based on facts and documentation.
• Review and approve medical treatment related to workers compensation claims, ensuring that recommended care aligns with applicable guidelines and claim parameters.
• Coordinate workplace accommodations with the employees manager when appropriate, supporting safe and timely return-to-work efforts.
• Independently investigate claims, analyze medical documentation, and make well-reasoned compensability recommendations in accordance with applicable laws and policies.
• Partner with internal stakeholders on more complex compensability decisions as needed, providing insight and recommendations on claim strategy.
• Manage all claim activity and documentation within American Technical Services (ATS) software, ensuring records are complete, accurate, and compliant.
• Work a consistent schedule of Monday through Friday, 8:00 AM to 5:00 PM, meeting deadlines and service expectations for claim handling.
• Support a positive experience for injured employees by communicating clearly, responding promptly to inquiries, and guiding them through the claims process.

Essential Skills:

• 3-5+ years of workers compensation claims experience, with demonstrated ability to manage a high-volume caseload.
• Active North Carolina Property & Casualty Insurance Adjuster License, with authorization to handle workers compensation claims.
• Experience specifically handling workers compensation claims, including coverage analysis and compensability determinations.
• Proficiency with Microsoft Office Suite, including Word, Excel, Outlook, and related tools for documentation and communication.
• Ability to independently investigate claims, including obtaining statements, reviewing medical documentation, and evaluating facts.
• Ability to review and interpret medical records to support compensability decisions and treatment approvals.
• Strong decision-making skills to make clear, defensible compensability recommendations under the Workers Compensation Act.
• Effective verbal and written communication skills to interact professionally with injured employees, managers, and internal stakeholders.
• Strong organizational skills to manage 6075 active claims simultaneously while handling new claim intake and closures.
• Ability to work effectively in a fully remote environment, managing time, tasks, and priorities with minimal direct supervision.
• Bachelors degree (4-year degree) in a related field such as business, risk management, or a similar discipline.
• Experience working as a Workers Compensation Adjuster or Claims Specialist in a complex organizational setting.
• Familiarity with American Technical Services (ATS) or similar claims management software.
• Ability to collaborate with managers to develop and coordinate appropriate workplace accommodations.
• Strong attention to detail and documentation skills to ensure accurate and complete claim files.
• Customer service mindset with a focus on supporting injured employees throughout the claims process.
• Comfort working in a temporary assignment environment with a defined duration and potential for extension.

Benefits:

• Great benefits package
• Work life balance
• Stability and clear opportunities for growth into other areas of the dealership over time.

***INTERVIEWS

HAPPENING THIS WEEK***

This position is moving extremely fast as this is an urgent need for the client. If interested, please send over your most up to date resume along with your availability for a 10-minute phone call to dyseidenberg@astoncarter.com

Work Environment

This is a 100% remote position, allowing you to perform all responsibilities from a home or off-site office environment. The standard work schedule is Monday through Friday, 8:00 AM to 5:00 PM, with expectations for consistent availability during these hours to respond to new claims and support ongoing cases. You will use American Technical Services (ATS) claims software and the Microsoft Office Suite to manage documentation, communication, and reporting. The role is a temporary assignment of approximately three months to cover an employee on leave, with the possibility of extension if the leave is prolonged or the employee does not return as expected. The work environment emphasizes professional communication, accurate documentation, and collaboration with internal stakeholders, while providing the flexibility and focus of a fully remote setting.

This is a Contract position based out of Raleigh, NC.

The pay range for this position is $30.74 - $52.78/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)

This is a Contract position based out of Raleigh, NC.

This position is anticipated to close on Nov 21, 2026.

This is a fully remote position.

About Aston Carter

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® Platinum Award winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email astoncarteraccommodation@astoncarter.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.