Specialty Operations Coordinator

Role Overview

• Analyze low
• and mid-level workers compensation claims to determine benefits due.
• Ensure ongoing adjudication of claims within company standards and industry best practices.
• Adjust medical-only claims and low
• to mid-level lost-time workers compensation claims under close supervision.
• Support other claims staff with larger or more complex claims as necessary.
• Process workers compensation claims reviewing compensability, benefits due, and files necessary documentation with state agency.
• Communicate claim action/processing with appropriate parties including, but not limited to: claimant, client, state agency, managed care organization and appropriate medical contact.
• Ensure claims files are properly documented and claims coding is correct.
• Maintain professional client relationships.
• Coordinate actuarial/settlement issues impacting employers with rate and settlement departments.

Requirements

• High School diploma or GED required.
• Licenses as required.
• One (1) year of claims management experience or equivalent combination of education and experience required.
• Excellent oral and written communication skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Benefits

• Three Medical, and two dental plans to choose from.
• Tuition reimbursement eligible.
• 401K plan that matches 50% on every $ you put in up to the first 6% you save.
• 4 weeks PTO your first full year.