Claims Specialist III – WC

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

    Job Description:
  • Review claim assignments to determine policy coverage and compensability
  • Conduct interviews and research facts of a claim
  • Establish rapport with stakeholders throughout the recovery process
  • Analyze medical records and determine compensability
  • Propose vocational support when appropriate
  • Identify and document subrogation potential
  • Comply with Medicare Secondary Payor requirements
  • Periodically assess claim file reserves and risk factors
  • Execute technical claim handling functions
  • Engage in direct negotiation and mediation according to jurisdiction
  • Participate in continuing education opportunities
    Requirements:
  • High school diploma required; Bachelor’s degree preferred
  • 5+ years of general work experience
  • 10+ years of workers’ compensation claims handling experience
  • Meet state licensing requirements to handle claims
  • Within 1 year of hire, complete the Workers’ Recovery Professional (WRP) certification program
  • Within 3 years of hire, complete the Senior Workers’ Compensation Law Associate (SCLA) designation program
  • Proficient knowledge of insurance, medical and legal concepts
    Benefits:
  • Annual incentive compensation
  • Medical, dental, vision & life insurance
  • Accident, critical Illness & short-term disability insurance
  • Retirement plans with employer contributions
  • Generous time-off program
  • Programs designed to support the employee well-being and financial security.

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