About this role
Role Overview
- Attendance and completion of designated claims professional training program.
- Adjusting various levels of workers’ compensation claims under close supervision.
- Processing and responding to incoming mail, emails and other claim related documents according to status of the claim.
- Communicating effectively with injured workers, insureds/employers, medical providers, attorneys and carrier representatives.
- Thoroughly investigating new and existing claims by gathering relevant information.
- Investigating employer/employee relationships, policy verification, coverage and any potential for subrogation issues or fraud indicators.
- Determining coverage, compensability and appropriate benefits in accordance with jurisdictional guidelines.
- Documenting claims files and properly coding claim activity.
- Preparing detailed reports documenting findings and recommendations.
- Administering claim benefits through maintenance of calendared claim-related action items.
Requirements
- Education Requirement – High School Diploma or GED. Bachelor's degree preferred and 2 years of customer service experience and/or combination of education and experience.
Benefits
- Comprehensive benefits package including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.