Claims Return to Work Specialist

BerkleyNet is an innovative workers compensation insurance provider that does all our business online. Our Goal? To make doing business “Ridiculously Fast. Amazingly Easy.”

The Return to Work (RTW) Specialist advances BerkleyNet’s mission of delivering exceptional workers compensation outcomes by facilitating safe, timely, and sustainable return‑to‑work plans for injured employees. The role serves as a strategic partner to employers, injured workers, medical providers, and internal claims teams, ensuring that modified duty opportunities are identified, communicated, and implemented effectively. This position directly contributes to loss cost management, improved recovery outcomes, and an elevated customer experience by reducing disability duration and supporting early, collaborative return‑to‑work solutions.

• Coordinate individualized return‑to‑work plans that align with medical restrictions, employer capabilities, and jurisdictional requirements.
• Monitor medical progress and work status to ensure plans remain appropriate and updated as conditions evolve.
• Identify modified duty opportunities by partnering with employers to understand job tasks, essential functions, and potential accommodations.
• Evaluate work capacity and readiness using medical documentation, provider input, and claim facts.
• Recommend claim strategies that support early return‑to‑work, including transitional duty, ergonomic adjustments, or alternative placements.
• Exercise authority to approve or escalate RTW decisions in accordance with company guidelines and best practices.
• Collaborate with injured workers to set expectations, address barriers, and support a positive recovery experience.
• Partner with employers to educate them on RTW best practices, modified duty options, and program benefits.
• Communicate with medical providers to clarify restrictions, obtain updated work status, and align treatment plans with RTW goals.
• Maintain accurate RTW documentation within claim files, ensuring clarity, timeliness, and regulatory compliance.
• Track and report RTW metrics such as days away from work, transitional duty utilization, and program effectiveness.
• Ensure adherence to jurisdictional requirements related to work status forms, communication timelines, and accommodation obligations.
• Identify trends and opportunities to enhance BerkleyNet’s RTW program, tools, and employer resources.
• Support training and education initiatives for internal teams and external partners on RTW processes and best practices.
• Visibly supports the overall claims adjusting and managed care functions in multiple jurisdictions
• Assist claims management in monitoring and researching jurisdictional case law and statutory legal trends
• Demonstrate the use of tact and discretion in all communications and provides a positive contribution to the morale of the claims department
• Lead special projects as assigned by senior claims management
• Continuously strives to improve our product and business results through innovation
• Obtain and maintain adjuster license in multiple jurisdictions as required

This role requires working onsite Monday through Thursday, with the option to work remotely on Fridays, in one of the following office locations: Manassas VA, Richmond VA, Irving TX or Scottsdale AZ.

• Minimum of 2+ years of technical claims handling experience with a heavy emphasis on workers’ compensation claims in multiple jurisdictions
• Supervisory experience a plus, but not required
• Consistently display a high-level of ownership, drive, and accountability
• Acts as an informal leader
• Excellent written, verbal, interpersonal and relationship building skills
• Exceptional time management and organization skills
• Strong insurance business acumen and leadership skills
• Ability to work independently and strategically problem solve
• Strong analytical and critical thinking skills
• Ability to diplomatically manage conflict
• Ability to develop relationships within the organization and work effectively across departments
• Strong discretion and integrity in dealing with highly confidential and sensitive information
• Display a high degree of attention to detail

Education 

• Bachelor’s degree or equivalent work experience
• AIC, ARM, CCP or CPCU insurance designation preferred