Position Summary The Voucher Specialist plays a critical role in assisting injured workers with identifying and utilizing approved retraining options. This position manages a high-volume caseload, coordinating between injured workers, accredited schools, law offices, and claims administrators while ensuring strict compliance with HIPAA and document security regulations. Operating in a process-driven environment, the role balances customer service, case management, phone support, documentation, follow-up, and invoice processing.

Responsibilities:

- Manage and maintain a caseload of up to 150 cases, ensuring accurate tracking, documentation, and timely follow-up.

- Make a high volume of outbound calls to injured workers to provide updates, collect information, explain next steps, and follow up on pending items.

- Receive inbound calls from injured workers, schools, law offices, claims administrators, and internal teams.

- Assist injured workers with selecting and enrolling in approved retraining or educational programs, providing guidance throughout the process.

- Communicate with accredited schools and training centers to confirm enrollment requirements, pricing, paperwork, and voucher acceptance.

- Coordinate communication between injured workers, schools, and claims administrators to ensure smooth enrollment and timely updates.

- Prepare invoice packets and submit invoices to claims administrators for payment in an accurate and timely manner.

- Document all case activity clearly and accurately in internal case management systems.

- Handle intake and exit processes for injured workers, including collecting necessary documentation and ensuring proper case closure.





- Request voucher amendments or corrections from claims adjusters and follow up regarding unpaid benefits or pending invoices.

- Monitor and manage assigned callbacks daily, maintaining callback volume within departmental expectations.

- Respond to emails, voicemails, and case communications through shared inbox platforms within established turnaround times.

- Handle escalated requests or inquiries professionally and route issues to appropriate leads or supervisors when needed.

- Maintain strict compliance with HIPAA and all applicable state and federal privacy and security regulations.

- Participate in departmental quality, metric, and compliance audits to ensure accuracy and accountability of reported data.

- Support process updates, Kaizen initiatives, and continuous improvement efforts to help streamline workflows and enhance performance.

Requirements:

- High school diploma or equivalent.

- Proficiency with computers, office software, video conferencing, Google Workspace, and shared inbox platforms.

- Experience using internal case management systems, phone queues, call routing, and documentation tools.

- Strong verbal communication skills with the ability to handle high call volumes, sensitive conversations, and escalated concerns.





- Professional written communication skills for producing clear, concise, and courteous email correspondence.

- Strong organization and follow-up skills to manage multiple cases, pending tasks, and strict deadlines simultaneously.

- Conflict resolution and problem-solving skills to manage difficult or emotional calls with tact and patience.

- High attention to detail when documenting case activity, preparing invoice packets, and reviewing case statuses.

- Ability to work in a high-volume, process-driven environment involving repetitive tasks, frequent phone calls, and detailed documentation.

- Strict adherence to HIPAA and federal and state privacy regulations concerning sensitive medical and legal information.

Nice to Have:

- One to two or more years of experience in call center, customer service, collections, sales, medical office, case management, or social work roles.

- Bilingual language skills, particularly in Spanish or other languages.

- Previous workers compensation industry experience.

What Success Looks Like:

- Maintaining a minimum of 345 outbound calls and sending at least 200 emails per month.

- Maintaining assigned callback volume at fewer than 25 callbacks daily with average email reply times under 24 hours.

- Submitting a minimum goal of 40 invoices per month while maintaining an average case turnaround time under 25 days.

- Maintaining fewer than 3 Return-to-Work holds assigned at any given time.

- Achieving high Quality Assurance scores with fewer than 3 findings per audit cycle and fewer than 1 escalation on average.

📌 Voucher Case Specialist (Monterrey)
🏢 Amalga Group
📍 Monterrey