Claims Service Representative I- Workers' Compensation

Richfield, Ohio
Not Specified
Sep 29, 2016
Nov 28, 2016
Job Type
Not Specified
Career Level
Not Specified

With over 25 years of success, National Interstate (NASDAQ: NATL) is one of the leading specialty property and casualty insurance companies in the country. We offer more than 30 product lines with a focus on commercial transportation, Alternative Risk Transfer (ART), and specialty vehicle insurance. Here at National Interstate, we believe that providing quality and commitment to our customers as well as our employees is paramount to our success. Thanks to our talented and dedicated team, we are truly able to build an insurance experience around you. If you are ready to join an engaging and driven team such as ours, we would love to hear from you!

Key aspects of this role:

Maintain an active diary for all WC disability claimants, issue timely and accurate disability payments to them under the authority of the claims handler, submit required EDI data entry and issue all required state forms to start or suspend disability payments. This position calls for strong math and organization skills.

  • Responsible for maintaining a diary of all active WC lost-time claimants, as given by claim adjusters.

  • Calculate all necessary disability payments for designated time periods; calculate TPD rates when claimant has returned to work with a loss of earning.

  • Issue all disability payments (TTD, TPD, PPD or PTD) on a weekly or bi-weekly basis, under the authority given by the claims adjuster.

  • Follow up with the adjuster two days before a payment is due to be issued if authority was not extended.

  • Issue required notices and/or state forms when initiating disability payments or suspending of disability.

  • EDI data entry of state forms that correlate to starting, modifying, or suspending disability payments, as required by specific venues.

  • Prepare letters and copies to mail necessary forms to the claimant.

  • Enter clear and concise file notes with actions taken.

  • Assist in telephone calls, incoming or outgoing, such as claimant seeking information relating to his disability check.

  • Issue necessary Stop Pay notices on any disability checks not received by the claimant. Seek authority to reissue.

  • Other duties as assigned by the supervisor.

Skills and background we are looking for:

  • High school diploma or equivalent.

  • Working knowledge in the insurance industry, preferably in claims.

  • General knowledge of workers' compensation and/or Med Pay/PIP claims is helpful.

  • Strong math skills.

  • Ability to read claim information, such as file notes, payroll records, medical reports, legal documents, policy language, billing information, etc., with adequate comprehension to determine the urgency of material and how to handle such material with the ability to clearly add the information to file notes.

  • Ability to prepare written documentation in a professional manner via letter or email, as requested by the supervisor or claims handler.

  • Ability to professionally handle incoming telephone calls or make outgoing calls, as requested by the supervisor or claims handler.

  • Working knowledge of Microsoft Word, Excel and Outlook.