Job Description: Creative Risk Solutions (CRS), a proud line of business under the Holmes Murphy umbrella, is a leading Third-Party Administrator (TPA) specializing in innovative claims management solutions. At CRS, we believe in doing things differently—empowering our team to deliver exceptional service, embrace creativity, and make a real impact for our clients. We are looking to add a Workers’ Compensation Claims Specialist to join our team. Experience handling Colorado claims is required. Essential Responsibilities: - Receives, gathers and accurately transmits workers’ compensation information to the company, from communications with the insured, claimants, and internal staff in a timely manner. - Investigates, evaluates, and resolves lost time Workers’ Compensation claims, including litigated claims. - Mediates situations as they arise between the insured and the insurance company, with little to no support from leader, to include researching coverage issues. - Enters and maintains accurate information on a computer system during the claim process, to include final settlement information. - Generates checks for indemnity and medical payments daily. - Develops and monitors consistency in procedural matters of claims handling process within CRS. - Willingness to become licensed if required in jurisdiction where claims are handled. Qualifications: - Education: High school diploma; college degree preferred. Technical designations encouraged, such as AIC and CPCU. - Experience: 3-5 years claims experience with strong background in Workers’ Compensation claims handling. Must have experience handling Colorado claims. - Licensing: Active state specific Workers Compensation License required or the ability to acquire license within three months of hire. - Skills: An ideal candidate will have proficient knowledge of Workers’ Compensation insurance coverage and claims processing procedures. They will possess the ability to adjudicate lost time claims across multiple jurisdictions and demonstrate the capacity to quickly learn and adapt to various software programs. - Technical Competencies: An ideal candidate will have a strong grasp of claims principles, practices, and insurance coverage interpretation, contributing to workflows and adhering to compliance requirements. They will prioritize problem-solving, actively foster relationships, and collaborate to deliver impactful solutions and a world-class client experience. Here’s a little bit about us: Creative Risk Solutions is a leading provider of innovative risk management solutions. We specialize in delivering customized claims management, loss control, and risk consulting services to our clients. Our team is dedicated to excellence, integrity, and creating value for our clients through proactive risk management strategies. In addition to being great at what you do, we place a high emphasis on building a best-in-class culture. We do this through empowering employees to build trust through honest and caring actions, ensuring clear and constructive communication, establishing meaningful client relationships that support their unique potential, and contributing to the organization's success by effectively influencing and uplifting team members. Benefits: In addition to core benefits like health, dental and vision, also enjoy benefits such as: - Paid Parental Leave and supportive New Parent Benefits — We know being a working parent is hard, and we want to support our employees in this journey! - Company paid continuing Education & Tuition Reimbursement — We support those who want to develop and grow. - 401k Profit Sharing — Each year, Holmes Murphy makes a lump sum contribution to every full-time employee’s 401k. This means, even if you’re not in a position to set money aside for the future at any point in time, Holmes Murphy will do it on your behalf! We are forward-thinking and want to be sure your future is cared for. - Generous time off practices in addition to paid holidays — Yes, we actually encourage employees to use their time off, and they do. After all, you can’t be at your best for our clients if you’re not at your best for yourself first. - Supportive of community efforts with paid Volunteer time off and employee matching gifts to charities that are important to you — Through our Holmes Murphy Foundation, we offer several vehicles where you can make an impact and care for those around you. - DE&I programs — Holmes Murphy is committed to celebrating every employee’s unique diversity, equity, and inclusion (DE&I) experience with us. Not only do we offer all employees a paid Diversity Day time off option, but we also have a Chief Diversity Officer on hand, as well as a DE&I project team, committee, and interest group. You will have the opportunity to take part in those if you wish! - Consistent merit increase and promotion opportunities — Annually, employees are reviewed for merit increases and promotion opportunities because we believe growth is important — not only with your financial wellbeing, but also your career wellbeing. - Discretionary bonus opportunity — Yes, there is an annual opportunity to make more money. Who doesn’t love that?! Holmes Murphy & Associates is an Equal Opportunity Employer. The salary range for this role is $57,500– $98,900. Compensation is based on several factors, including, but not limited to, education, work experience and industry certifications. In addition to your salary, Holmes Murphy offers a comprehensive total rewards program including annual bonuses, total wellbeing benefits and support for professional development. #LI-SM1

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Coordinate effective resolution of member or provider/practitioner appeals. Responsible for managing to resolution of appeals, complaints and grievances scenarios for all products, which contain multiple issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and deviation from standard processes to complete. May have contact with outside plan sponsors or regulators. -Research and resolve incoming electronic appeals, complaints and grievances as appropriate as a “single-point-of-contact” based on type of case. -Can identify and reroute inappropriate work items that do not meet appeal, complaint and grievance criteria as well as identify trends in misrouted work. -Assemble all data used in making denial determinations and can act as subject matter expert with regards to unit workflows, appeals, complaints and grievances processes and procedures. -Can review a clinical determination and understand rationale for decision. -Able to research claim processing logic and various systems to verify accuracy of claim payment, member eligibility data, billing/payment status, and prior to initiation of the appeal process. -Serves as point person for newer staff in answering questions associated with claims/customer service systems and products. -Educates team mates as well as other areas on all components within member or provider/practitioner appeals, complaints and grievances for all products and services. -Coordinates efforts both internally and across departments to successfully resolve claims research, SPD/COC interpretation, letter content, state or federal regulatory language, triaging of appeals, complaints and grievances, and similar situations requiring a higher level of expertise. -Identifies trends and emerging issues and reports on and gives input on potential solutions. -Delivers internal quality reviews, provides appropriate support in third party audits, customer meetings, regulatory meetings and consultant meetings when required. -Understands and can respond to ERT/SMRT/DOI/BBB appeals, complaints and grievances Required Qualifications Excellent written and oral communication skills. Ability to work cross organizationally. Strong analytical skills focusing on accuracy and attention to detail. Preferred Qualifications Experience in reading or researching benefit language. Experience in research and analysis of claim processing a plus. Demonstrated ability to handle multiple assignments competently, accurately and efficiently. Ability to maintain accuracy and production standards. Education Associate's degree or equivalent work experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $18.50 - $35.29 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: - Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. - No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. - Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 03/31/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves managing a caseload of workers' compensation claims. - Review new claims, gather information, and determine compensability - Conduct thorough investigations into the circumstances of workplace injuries - Obtain medical records and witness statements - Calculate and authorize indemnity benefits, including temporary total disability, permanent partial disability, and vocational rehabilitation benefits - Ensure compliance with state workers' compensation laws, regulations, and reporting requirements - Maintain accurate and detailed claim files, documenting all relevant information, communications, and decisions Qualifications - 3+ years of experience handling Workers Compensation/Indemnity Claims for MN, WI, NE, and IA - Must have experience handling litigated files - Strong knowledge of workers' compensation laws, regulations, and medical terminology - Excellent communication, negotiation, and customer service skills Benefits - $75,000-85,000/year - 4% annual bonus - Full medical benefits - 401(k) with employer match Company Description The Jonus Group is a leading insurance staffing firm specializing in providing top-tier talent for the insurance industry. We are currently seeking a dedicated and experienced Workers Compensation Claims Adjuster to join a reputable insurance client's Workers Compensation Claims Department.

• Submit copay claims through appropriate channels and follow through to payment posting • Work closely with our Financial Navigation team to ensure accurate and timely processing of claims • Communicate with manufacturer copay programs and foundation copay programs to resolve any issues or discrepancies • Communicate effectively with customer’s revenue cycle department to resolve any issues or discrepancies • Maintain accurate records of all claims processed • Meet productivity and quality standards