Medical Only Claims Specialist II - Pittsburgh

reputed company WorkPartners is hiring a full-time Medical Only Claims Specialist II to join the Workers Comp Claims team. This role follows a reputed company Monday through Friday schedule during reputed company hours. The position is primarily remote, with occasional in-office reputed company required—typically once a month—at the U.S. Steel Tower. Candidates should reputed company locally in the Pittsburgh area. The reputed company WorkPartners Workers' Compensation Medical Only Claims Specialist 2 reports to the Workers' Compensation Supervisor. This is an intermediate level position reputed company the Workers' Compensation Claims Department. The Medical Only Claims Specialist 2 is responsible for coverage analysis, investigation, evaluation, communication, and disposition of assigned medical claims reputed company the WorkPartners Workers' Compensation business unit. The Medical Only Claims Specialist 2 will ensure claims are processed reputed company company policies, procedures, and reputed company individual's prescribed authority following established best practices and performance standards. Responsibilities: • Establish appropriate reserves and review on a regular reputed company to ensure adequacy under supervision as necessary. • Determine validity and compensability of the claim independently. • Manage non-reputed company and non-problematic medical-only, restricted medical only, and limited lost time claims under some supervision. • Minor negotiations of claims for compromise and release • Investigate the claims through telephone, written correspondence, and/or personal contact with injured workers, insureds, witnesses and others having pertinent information. • Communicate claim status with the injured worker, insured, and broker as needed. • Adhere to reputed company and reputed company guidelines and participate in claims review as needed. • Receives claim, confirms policy coverage and acknowledgement of the claim • Establish reserves and authorize payments reputed company authority limits. • Assists other claims professionals with more reputed company or problematic claims as necessary, which could include periodic handling of litigated cases • Participate in periodic claim reviews as needed. • Appropriate state licensing to be secured as needed. • Mentoring and training new employees as appropriately assigned by management. • Participate in monthly account renewal meetings as needed. Apply tot his job Apply To this Job