Workers' Compensation Claims Technician

About the role

Liberty Mutual Insurance has an excellent claims opportunity for a Workers Compensation Claims Technician. Claims Technicians obtain essential information to process routine workers' compensation claims with ongoing medical management for medical pension claims. You will provide injured workers and customers with accurate, timely information and quality service, identify potential problems, and make claim referral decisions.

GRS North America Claims offers the flexibility to work from home full-time. Candidates selected for this position will be trained remotely. If you reside within 50 miles of a specified office, you will be required to go into the office twice a month. Please note this policy is subject to change.

Responsibilities

• Conduct investigations to secure essential facts from injured workers, employers, and providers regarding workers' compensation through telephone or written reports.
• Verify information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment, and evaluate cases with claim-specific ongoing medical management.
• Provide ongoing medical case management for assigned claims. Initiate calls to injured workers and medical providers if projected disability exceeds maximum triage model projection or to resolve medical treatment issues as needed.
• Maintain contact with injured workers, providers, and employers to ensure understanding of protocols, claims processing, and medical treatment.
• Continually assess claim status to determine if problem cases or those exceeding protocols should be referred to the Claims Service Team and/or would benefit from MP RN review or other medical/claims resources.
• Arrange Independent Medical Exams and Peer Reviews as necessary.
• Maintain accurate records and handle administrative responsibilities associated with processing and payment of claims. Record and update status notes, document results of contacts, relevant medical reports, and duration information per file posting standards, including making appropriate medical information viewable to customers in Electronic Document Management (EDM).
• Generate form letters following set guidelines (e.g., letters to physicians projecting disability, letters confirming medical treatment and disability, and letters outlining expected outcomes to employers).
• Authorize payment of medical payments and/or medical treatment.
• Recognize potential subrogation cases, prepare cases for subrogation, and refer these cases to the Subrogation Units.

Requirements

• High school diploma plus 1-3 years of related customer service experience or applicable insurance knowledge.
• Licensing required in some states.
• Effective analytical skills to learn and apply basic policy/contract coverage and recognize questionable coverage/contract situations (which necessitate supervisory involvement).
• Effective interpersonal skills to explain facts and logic used to arrive at decisions in a way the customer understands.
• Effective written skills to compose clear, succinct descriptions when posting files and drafting correspondence.
• Good telephone and typing skills.
• Ability to learn when to make proper use of medical management resources, know when to use them, and follow through with medical management information received.

Benefits

Liberty Mutual offers a comprehensive benefits package designed to support your life and well-being. To learn more about our benefit offerings, please visit: Liberty Mutual Benefits.

Pay

The typical starting salary range for this role is determined by skills, experience, education, certifications, and location. The full salary range reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.