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.