Workers Compensation Claims Representative – Medical Only VA Jurisdiction

Role Overview

• Analyze Virginia Medical Only claims on behalf of our valued clients to determine benefits due.
• Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Process low level workers compensation claims determining compensability and benefits due on long term indemnity claims.
• Develop and coordinate low level workers compensation claims' action plans to resolution, return-to-work efforts, and approve claim payments.
• Approve and process assigned claims, determine benefits due, and administer action plan pursuant to the claim or client contract.
• Administer subrogation of claims and negotiate settlements.
• Communicate claim action with claimant and client.
• Ensure claim files are properly documented and claims coding is correct.
• Maintain professional client relationships.

Requirements

• 2 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Jurisdiction Knowledge: VA

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.