DEPARTMENT: CLAIMS
REPORTS TO: CLAIMS SUPERVISOR
STATUS: NON-EXEMPT
SCHEDULE: M-F 8a-5p
REQUIREMENTS:
- High School Diploma or equivalent required, college degree preferred.
- Computer literacy; familiarity with Microsoft Office suite.
- This individual will adhere to the code of ethical conduct and is required to
engage in fair claims settlement practice in accordance with the workers’
compensation law.
- Minimum of one to two years relevant claims experience in the worker’s
compensation field or similar experience is desired.
JOB SUMMARY:
- Independently process/administer benefits on multi-state medical only claims
and process medical only direct pay, and incident only claims from start to finish.
- Responsible for diary maintenance, reviewing medical case notes, scheduling
independent medical examinations, reserving, authorizing payments and identifying
the differences between compensable and non-compensable situations.
- Recognition of 3rd party liability and subrogation handling through recovery.
- Identify and review the need for medical case management to a specific loss
and direct/manage activity relative to managed care.
- Document claim file activities
SKILL AND ABILITY PROFILE:
- Good listening; and good written, communication, and organizational skills
- Strongly detail oriented.
- Ability to multi-task and stronghold the understanding of human nature and
motivation principles.
- Readily control/handle problem issues in times of stress, and/or in a climate of
conflict or adversity.
- Responsiveness to changing business or customer needs.
If interested, please e-mail resume and cover letter to:
