Claims Associate - Workers Compensation

About the role

To be oriented and trained as a new industry professional with the ability to analyze workers compensation claims and determine benefits due. You’ll adjust medical-only claims and minor lost-time workers compensation claims under close supervision, support other claims representatives with larger or more complex claims, and maintain professional client relationships.

Responsibilities

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented, and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

Requirements

• High school diploma or GED required.
• Strong oral and written communication skills.
• Computer literate – including Microsoft Office.
• Organizational skills.
• Clerical or customer service experience or equivalent combination of education and experience preferred.

Work Environment

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Computer keyboarding.
• Auditory/Visual: Hearing, vision and talking.
• When applicable and appropriate, consideration will be given to reasonable accommodations.

Benefits

• Flexible work schedule and ability to work in an agile environment.
• Referral incentive program.
• Career development and promotional growth opportunities.
• Comprehensive benefits package including medical, dental, vision, and 401K with matching.
• Paid time off (PTO).
• Disability and life insurance.
• Employee assistance program.
• Flexible spending or health savings account.
• Additional voluntary benefits.

Pay

For the jurisdiction noted in this job posting, the range of starting pay for this role is $20–$24/hour.