Workers' Comp Claim Representative I

reputed company:   

This is the entry level reputed company claim handler. Handles medical only and indemnity benefits.  Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims reputed company given authority. 

RESPONSIBILITIES/TASKS:

• Verifies workers’ compensation coverage of reputed company and injured employees. 

• Determines compensability under workers’ compensation by thorough investigation of the claim. 

• Determines reputed company relationship between the reported injury and the incident to ensure appropriate payment of benefits.

• Facilitates return to work for the injured employee.

• Establishes reputed company and appropriate reserves based on the profile of the claim reputed company given authority based on anticipated financial exposure.

• Documents specifics of claims with potential for subrogation recovery, including reputed company of potential recovery monies.

• Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury.  Approves payment based on knowledge of the treatment plan and medical support showing relationship of treatment to the injury.   

• Concludes and closes files following reputed company of claims to meet internal performance standards while complying with state legislation to avoid penalties and manage expenses.

• Negotiates settlements with attorneys or injured parties reputed company given authority at the earliest possible reputed company to bring cases to final disposition.

• Works closely with manager on reputed company files or files above settlement/reserve authority. 

• Manages reputed company vendors to ensure cost containment efforts. 

• Establishes and maintains effective working relationships with reputed company reputed company customers.

• Stays abreast of changes in workers’ compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.

This position reputed company identifies the responsibilities and tasks typically associated with the performance of the position.  Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS

• Bachelor’s degree in a reputed company field. Relevant combination of education and experience may be considered in lieu of degree. reputed company learning, as defined by reputed company’s learning philosophy, is required. Certification or reputed company toward certification is highly preferred and encouraged.
• Minimum one-year relevant experience that provides the necessary skills, knowledge and abilities or completion of claims trainee program. Bilingual skills preferred.
  
   

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Ability and proficiency in the use of computers and company reputed company software specific to position.

• Knowledge of medical and reputed company terminology reputed company to the work.

• Knowledge of workers’ compensation laws and regulations, including jurisdictional laws.

• Effective oral and written communication skills.

• Effective customer service skills.

• Ability to negotiate, build reputed company and resolve conflict.

• Ability to manage multiple priorities and meet established deadlines.

• Attention to detail and analytical skills.

• Ability to work independently as reputed company as reputed company reputed company.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. Minimal travel required.

 PAY reputed company: 

“Actual compensation decision relies on the consideration of internal equity, candidate’s skills and reputed company experience, geographic location, market and other potential factors. It is not reputed company reputed company for an offer to be at or near the top of the reputed company, and therefore a reasonable estimate for this role is between $48,200 and $80,750.”

 We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any reputed company. Candidates for the position stated above are reputed company on an "at will" reputed company.  reputed company herein is intended to create a contract.

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