Top 2452 Workers compensation claims representative Jobs

Workers Compensation Claims Examiner
Association County Commissioners of GA —Atlanta, GA
- From $75,000 a year
- Full-time
- Remote
- Basic math
- English
- Mid-level
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Claims Consultant
Risk Strategies —Remote
- $100,000 - $130,000 a year
- Full-time
- 5 years
- Analysis skills
- Bachelor's degree
Workers’ Compensation Specialist
TransPak, Inc. —Remote
- $40,000 - $70,000 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Bachelor's degree
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Claims Representative – Examiner – Workers’ Compensation
RAS Companies —Milwaukee, WI
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Communication skills
- Paid parental leave
- Paid holidays
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Workers Compensation Claims Representative
SYNTRIQ HEALTH SOLUTIONS LLC —Corinth, MS
- Full-time
- Microsoft Outlook
- Computer literacy
- HIPAA
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Senior Claims Representative (Remote)
MEM —Remote
- $72,800 - $109,200 a year
- Full-time
- Remote
- 7 years
- Driver's License
- Bachelor's degree
- Profit sharing
- Paid jury duty
12d
Claims Representative (IAP): Workers Compensation Training Program | West Hills, CA
Sedgwick —West Hills, CA
- No experience needed
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
9d
WORKERS' COMPENSATION ANALYST
LA Metro —Los Angeles, CA
- $67,329.60 - $100,942.40 a year
- Temporary
- Writing skills
- English
- Mid-level
- Paid jury duty
- AD&D insurance
8d
Claims Representative (IAP) - Workers Compensation Training Program | San Diego, CA
Sedgwick —San Diego, CA
- Full-time
- Office
- High school diploma or GED
- Bachelor's degree
- Health savings account
- Disability insurance
10d
Claims Representative (IAP): Workers Compensation Training Program | Concord, CA
Sedgwick —Concord, CA
- Full-time
- No experience needed
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
11d
Claims Representative (IAP) - Workers Compensation Training Program, Long Beach, CA
Sedgwick —Long Beach, CA
- Full-time
- Office
- High school diploma or GED
- Bachelor's degree
- Health savings account
- Disability insurance
11d
Workers Compensation Claims Examiner (California Jurisdiction)
Elite —Remote
- Urgently hiring
- Remote
- Management
- Bachelor of Science
- Basic math
- On-the-job training
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Workers Compensation Claims Examiner (TEXAS Jurisdiction)
Elite —Remote
- Urgently hiring
- Remote
- Management
- Bachelor of Science
- Basic math
- On-the-job training
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Appeals Specialist - Hospital Billing, Underpayments
Aspirion —Atlanta, GA
- $20 - $26 an hour
- Full-time
- Remote
- Research
- High school diploma or GED
- Bachelor's degree
- Work from home
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Entry Level Claims Analyst - Workman's Compensation
Aspirion —Columbus, GA
- $17 - $19 an hour
- Full-time
- Remote
- Computer literacy
- Medical office experience
- HIPAA
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Workers Compensation Claims Specialist, Sr
NJM Insurance Group —Pittsburgh, PA
- $79,129 - $91,834 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- 5 years
- Paid parental leave
- Disability insurance
Claims Representative (IAP): Workers Compensation Training Program | Rancho Cordova, CA
Sedgwick —Rancho Cordova, CA
- No experience needed
- Office
- High school diploma or GED
- Health savings account
- Disability insurance
9d
Insurance Follow-up Representative
Catholic Health —Melville, NY
- $24 - $31 an hour
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Tuition reimbursement
Workers' Comp Claim Representative III - CA
Emergent Holdings —California
- $64,900 - $1,087,000 a year
- Full-time
- Bilingual
- Customer service
- 5 years
Workers Compensation Claims Representative
Auto-Owners Insurance Company —Lake Elmo, MN
- $50,000 - $81,500 a year
- Full-time
- Mid-level
- Bachelor's degree
- US work authorization
- Paid holidays
- Paid time off
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Workers Compensation Claims Examiner

Association County Commissioners of GA
Atlanta, GA

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Job Details

Full-time
From $75,000 a year

Qualifications

Computer operation
Customer communication
Basic math
Regulatory compliance in claims processing
Employee relationship building
English
Workers' compensation insurance knowledge
Driver's License
Insurance regulation
Typing

Full Job Description

Candidate selected to fill this position must have a permanent living address within the state of Georgia. The employee's telecommuting work location will be within a designated and approved workspace at the employee's home address.

General Definition of Work

Performs skilled technical work managing and resolving assigned lost time and complex medical only claims on behalf of the Association's insurance programs to ensure prompt determination of compensability, payment of entitled benefits, litigation management and effective claim resolution, and related work as apparent or assigned. Work is performed under the supervision of the Claims Supervisor.

Qualification Requirements

To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.

Position Responsibilities

Supports the Association through the support of division or program staff and interaction with local governments and authorities; exhibits knowledge and general understanding of the programs and services offered by the Association, and provides outstanding customer support that reflects well on the entire Association.
Initiates initial investigation for newly assigned insurance claims; confirms coverage of claim, contacts member, member representative, non-represented claimants, claimant's attorney and/or injured employees to obtain/provide information.
Initiates compensability and/or liability determination through completion of statements, recorded statements, on-site investigations.
Sets initial reserves for claims; performs proper and timely reserve evaluations and adjustments; reviews and approves bills for processing; reviews medical/rehabilitation notes; reviews and signs off daily check sheet; prepares and submits reports to excess carriers when loss is greater than one-half retention level.
Establishes and maintains proper claim diary requirements of existing caseloads with documentation of action plans; ensures action plans are adhered to in a timely manner.
Receives and responds to inquiries and requests for information from members, injured employees, vendors, case managers, legal representatives and medical providers.
Completes Electronic Data Interchange (EDI) transmissions, state board filings and completes Centers for Medicare Services (CMS) requirements.
Utilizes cost control measures regarding claims management when applicable including One Call Medical, Align, Telephonic Case Manager (TCM), Field Case Manager (FCM) and Surveillance; works at eliminating the payment of fines and penalties due to late and/or form filings.
Occasional overnight travel required – less than 20 days per year – i.e. travel to mediations, hearings, depositions, account/member visits, and seminars.

Knowledge, Skills and Abilities

Thorough knowledge of business English, spelling and arithmetic, standard office practices, procedures, equipment and administrative support techniques;
Thorough knowledge of the workers' compensation system requirements and medical only claim administration;
General knowledge of the laws, legal codes, court procedures, precedents, government regulations and agency rules regulating the workers compensation insurance industries; ability to make arithmetical calculations; ability to operate a variety of standard office equipment including personal computer and associated software;
Ability to communicate ideas effectively in both oral and written formats; ability to type accurately at a reasonable rate of speed; ability to follow oral and written instructions; ability to read and understand detailed and complicated policies, procedures and materials that contain specialized words and phrases;
Ability to establish and maintain effective working relationships with associates, claimants, attorneys, Nurse Case Managers, physicians, local government officials, customers and the general public.

Education and Experience

Bachelor's degree with coursework in business administration, insurance, or related field and
Intermediate level experience in the full scope of workers' compensation claim administration, or
Equivalent combination of education and experience.
AIC, ARM, and/or CPCU Professional Designations desired

Physical Requirements

This work requires the occasional exertion of up to 10 pounds of force;
Work regularly requires sitting, speaking or hearing, using hands to finger, handle or feel and reaching with hands and arms and occasionally requires standing, walking, climbing or balancing, stooping, kneeling, crouching or crawling, pushing or pulling, lifting and repetitive motions;
Work has standard vision requirements; vocal communication is required for expressing or exchanging ideas by means of the spoken word; hearing is required to perceive information at normal spoken word levels;
Work requires preparing and analyzing written or computer data, operating motor vehicles or equipment and observing general surroundings and activities;
Requires light physical effort working almost exclusively with light weight materials (up to 25 pounds) or short periods in difficult work positions.
Working conditions with absence of disagreeable conditions and little or no accident or health hazards; considerable mental effort and stress involved which could result in tension or anxiety.

Special Requirements

Employee is required to have and maintain a high-speed, broadband internet connection at their work site that is sufficient to enable fast, consistent service to the membership. A minimum download speed of 25 Mbps is required. To ensure a consistent speed at this level, a 40MB internet connection is recommended. You may check your download speed at speedtest.net.
Possession of or ability to acquire a Georgia Adjusters License issued through the State of Georgia Insurance Department within one year of employment.
Valid driver's license in the State of Georgia.

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