[Remote] Claims Professional
Note: The job is a remote job and is open to candidates in USA. Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. They are seeking a skilled Claims Specialist to manage workers' compensation claims and ensure effective communication between all stakeholders involved.
Responsibilities
• Manage a portfolio of modified duty and lost time claims with efficiency and accuracy.
• Forward medical records related to workplace injuries to the appropriate insurance adjuster.
• Input data from medical records into the system while maintaining attention to detail.
• Notify supervisors of initial diagnoses and work status for injured employees.
• Support the Hospital Manager and injured employees in implementing early return-to-work programs.
• Schedule and track follow-up doctor appointments, ensuring medical statuses are documented within 24 hours of each visit.
• Communicate appointment outcomes to insurance adjusters and supervisors promptly.
• Monitor lost time and modified work data, updating the system regularly.
• Maintain regular communication with insurance adjusters, providing updates at least every 60 days until claims are resolved.
• Conduct audits of claim data and related records consistently to ensure accuracy
Skills
• Minimum of 2 years of experience in handling workers' compensation claims.
• Strong understanding of medical management processes in workplace injury claims.
• Proficiency in data entry and maintaining accurate records.
• Effective communication skills for liaising with supervisors, insurance adjusters, and medical professionals.
• Ability to organize and track follow-up appointments and outcomes efficiently.
• Experience with auditing claim and related data to ensure compliance and accuracy.
• Familiarity with early return-to-work programs for injured employees.
• Knowledge of workers' compensation regulations and procedures.
Benefits
• Medical, vision, dental, and life and disability insurance
• 401(k) plan
Company Overview
• At Robert Half, we prioritize your security—if you believe you've encountered a scam or fraudulent recruiter, please report it immediately to https://www.roberthalf.com/us/en/fraud-alert. It was founded in 1948, and is headquartered in Menlo Park, California, USA, with a workforce of 10001+ employees. Its website is http://www.roberthalf.com/.
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