Claims Operations Associate

With over 35 years of proven expertise in the workers' compensation industry, Key Risk delivers innovative and responsive solutions that provide our clients the freedom to do what they do best. Offering guaranteed cost options to employers nationwide, Key Risk focuses on delivering products and services within specialized verticals to reduce workers' compensation exposures and deliver industry-leading results. All products and services are distributed through appointed insurance agents and brokers. Key Risk is a member company of W. R. Berkley Corporation, whose insurance company subsidiaries are rated A+ (Superior), Financial Size Category XV by A.M. Best Company and A+ (Strong) by S&P.

Responsibilities

• Maintain good lines of communication with employers, adjusters, and providers.
• Discuss with an employer issues relative to an injured worker’s return to work status.
• Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only.
• Timely and accurately reserve for medical-only claims assigned.
• Document relevant written and oral communication received relative to medical-only claims in the log notes.
• Discuss with an employee issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued.
• Assist in the management of communication of the unit with customers, providers, and injured employees.
• Enter medical notes into claim log as required.
• Index images as needed.
• Identify potential subrogation claims and notify appropriate supervisor.

Requirements

• BA/BS Degree.
• 0-2 years of workers compensation claims experience.
• Adjuster license strongly desired or ability to obtain license within six months.
• Knowledge of appropriate insurance principles and laws of workers’ compensation, preferably jurisdiction specific.
• Strong verbal and written communication.
• Strong interpersonal, time management, and organizational skills.
• Strong negotiation skills.
• Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to detail.
• Ability to perform with a sense of urgency.
• Ability to work both independently and within a team environment.
• Ability to travel for business purposes, approximately less than 10%.

We do not accept any unsolicited resumes from external recruiting agencies or firms. The actual salary for this position will be determined by a number of factors, including the scope, complexity, and location of the role; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. Sponsorship is not offered for this role.