Hybrid Claims Representative – Workers Compensation, Multi State

Posted last month

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About the role

  • 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

Job type

Experience level

JuniorMid level

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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