Claims Resolution Specialist

Job Details and Description

We are seeking a high-energy, goal-oriented Claims Resolution Specialist to join our growing team in Andover, Massachusetts. Under general supervision, the Claims Resolution Specialist performs a variety of professional duties in support of IWP’s pharmacy services. This position is responsible for expediting payment from workers’ compensation insurance carriers, monitoring electronic billing rejections, and maintaining accounts receivable. This is a phone-based position, Monday through Friday, from 8:30 am to 5:00 pm.

What You’ll Do

• Review, investigate, and analyze claims to maximize recovery
• Monitor electronic billing rejections and take appropriate action
• Ensure proper filing of invoices and monitor billing statuses less than 60 days outstanding
• Develop and maintain internal systems for data collection and entry, financial analysis, and report generation; create and update spreadsheets and logs as necessary
• Serve as a liaison between insurance carriers, pharmacy benefit managers, patients, and internal company divisions
• Negotiate settlements with insurance carriers within their granted settlement authority level as needed
• Pursue subrogation and arrange for salvage to obtain maximum recovery

Who You Are

• An experienced customer service professional with the ability to work in a fast-paced group
• An investigative mind with outstanding attention to detail
• A professional demeanor with strong oral and written communication skills
• Proven experience generating and analyzing complex reports

What Sets You Apart

• Workers’ compensation experience
• Knowledge of medical terminology
• Collections, claims processing, and subrogation experience
• Bilingual in Spanish (conversational and written)

Why You’ll Love Working at IWP

Our culture is built on our ICARE values: Ingenuity, Collaboration, Advocacy, Respect, and Empowerment. These values guide how we support our patients — and how we support each other.

We offer:

• Monthly engagement events and larger annual celebrations (tent party, summer BBQ, Family Fun Day)
• Tuition reimbursement and an internal-first job posting philosophy to support career growth
• Onsite fitness center, free parking, and a competitive benefits package
• A positive, inclusive environment where employees feel valued, supported, and empowered

Make a Difference with IWP

Injured Workers Pharmacy (IWP) is proud to be THE Patient Advocate Pharmacy, helping injured workers around the country access their prescription medications with ease. As a specialized workers’ compensation home delivery pharmacy, we collaborate with the legal, medical, and insurance communities to help injured workers return to a productive life. At IWP we believe in our service, but it’s the people who make it a great place to work. We value our employees and strive for a culture of teambuilding, open mindedness, and fun. If that sounds like something you’d like to be part of, we’d love to hear from you! Your compensation will include a competitive salary, generous benefits, and opportunities for growth and development.

We are dedicated to attracting and retaining top talent with competitive and fair compensation. The salary range for this role is $22 - $26/hr.

IWP is an Equal Opportunity Employer. IWP does not discriminate on the basis of race, creed, color, religion, national origin, sex, sexual orientation, gender identity, age, physical or mental disability, or any other basis covered by appropriate law. All employment decisions are made on the basis of qualifications, merit, and business need. IWP is committed to providing reasonable accommodations for qualified individuals with physical and mental disabilities in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact us at human-resources@dwpsolutions.com We will make a determination on your request for reasonable accommodation on a case-by-case basis.