Workers Comp Medical Only Claims Specialist
Manage within company best practices lower-level non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional.
Essential Job Duties:
- Receives claim, confirms policy coverage and acknowledgement of the claim
- Determine validity and compensability of the claim
- Establish reserves and authorize payments within reserving authority limits
- Manage non-complex and non-problematic medical-only claims and minor lost-time workers' compensation claims under close supervision
- Communicate claim status with the customer and claimant and client
- Adhere to client and carrier guidelines and participate in claims review as needed
- Assists other claims professionals with more complex or problematic claims as necessary
- Requires regular and consistent attendance.
- Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
- Additional duties as required.
KNOWLEDGE & SKILLS:
- Excellent written and verbal communication skills
- PC literate, including Microsoft Office (Word, Excel)
- Ability to learn rapidly to develop knowledge and understanding of claims practice
- Ability to identify, analyze and solve problems
- Strong organizational skills
- Good interpersonal skills
- Ability to work independently
- Ability to work in a team environment
- Ability to meet or exceed performance competencies
- College degree preferred, work experience can substitute for educational requirement
- One (1) year of industry experience and claims management preferred