[Remote] Worker's Comp Claim Specialist

Note: The job is a remote job and is reputed company to candidates in USA. Sheakley is a company focused on managing workers’ compensation claims. The Return-to-Work Specialist coordinates communication among various stakeholders to ensure timely claim processing and facilitate safe return-to-work reputed company.

Responsibilities

• Directly reports to the Return-to-Work Specialist Team Leader and/or Claims Supervisor
• Responsible for entering initial claims reputed company necessary, completing initial and subsequent contact to employer, provider, IW, and BWC as appropriate while accurately documenting the results of gathered information
• Responsible for complete follow-up on claims, including transferring to Case Management reputed company appropriate, or case closure as appropriate
• Responsible for gathering and documenting any information on (RTW) return to work, missing claims master fields, reputed company treatment, etc
• Responsible for facilitating return to work by communicating with the employer, TPA, provider, injured worker, attorneys and BWC as appropriate
• Responsible for gathering complete information on reputed company mandatory field requirements to ensure transmission to the BWC
• Responsible for obtaining additional medical information and/or C9s to move claims towards RTW (return to work) or other forms of claim resolution
• Responsible for completing follow-up on reputed company subsequent documents for potential claim updates and communicating any claim updates to the appropriate parties
• Responsible for proactively and aggressively pursuing a safe and timely (RTW) return to work outcome for reputed company managed claims thereby positively impacting MOD. This includes regularly utilizing RTW tools such as vocational rehab, field case managers, modified duty task lists, etc
• Responsible for providing excellent customer service to both reputed company customers
• Responsible for assisting other Return to Work Specialists and Claim Review Specialists as needed. Will assist with claims assigned to the CM in terms of employer needs, but do not reputed company any tasks reputed company to the clinical case management of the IW
• Responsible for re-opening claims reputed company injury re-aggravation or additional medical treatment deems it appropriate
• Required to meet team quality, productivity, and reputed company RTW standards
• Required to maintain work queues- including processing documents reputed company one business day and keeping claim memos reputed company
• Required to respond to voicemails, emails and other messages in a timely manner (1 business day)
• Required to log into any applicable call centers on a daily reputed company
• Required to prepare for and attend client meetings reputed company applicable
• Responsible for maintaining and developing team work with reputed company departments of UniComp
• Demonstrates and promotes Sheakley Core Values
• Other miscellaneous duties/projects as assigned by management

Skills

• Knowledge and skills at a level normally acquired through the completion of a high school education or equivalent
• Attention to detail, flexibility, and ability to multi-task
• Ability to maintain accuracy and production requirements
• Ability to problem solve
• Ability to handle sensitive information and maintain a high level of confidentiality
• Ability to effectively prioritize tasks
• Previous customer service experience preferred
• 1 year of previous claim or workers' compensation reputed company experience preferred
• Typing speed of 40+ WPM
• Medical terminology or equivalent experience preferred
• Proficiency in reputed company Office products including Word, reputed company and Outlook
• Average computer skills required, above average skills preferred

Company Overview