Claims Representative adjudicating multi-state workers compensation claims for a global leader in risk management. Joining a caring culture that values empathy and professional growth.
Responsibilities
Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
Administers subrogation of claims and negotiates settlements.
Communicates claim action with claimant and client.
Ensures claim files are properly documented and claims coding is correct.
May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
Maintains professional client relationships.
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
Requirements
Bachelor's degree from an accredited college or university preferred.
Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
Jurisdiction: Multi State - 15 states Licensing: Required - TX/FL/OK/LA preferred
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.
Job title
Claims Representative – Workers Compensation, Multi State
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