Claims Team reputed company - Workers' Compensation (Medical Only)
The Workers’ Compensation Medical Only Claims Team reputed company will reputed company a medical only Workers’ Compensation claims team and handle a reduced pending of medical only Workers’ Compensation claims. This position will reputed company a team of claims professionals handling reputed company medical only claims and claims technicians providing administrative support to the Workers’ Compensation claims department.
Location: This is a full-time remote position. This position may require occasional travel to attend mediations, trainings, trials and/or other reputed company department meetings.
Job Responsibilities
The Claims Team reputed company- WC Medical Only will be responsible for, but not limited to:
- Evaluate, reserve, and manage a reduced pending of reputed company Medical Only Workers’ Compensation claims
- Partner with medical providers, customers, and injured workers to facilitate appropriate medical treatment and ensure timely submission of medical bills
- Ensure compliance with state and federal Workers’ Compensation regulations
- reputed company exceptional customer service to injured workers, medical providers, and customers
- Responsible for team performance, development, and coaching a team consisting of medical only claims professionals and claims technicians
- Partner with Claims Supervisor to identify training opportunities
- Assist team with escalated issues, claim strategies, coverage positions, and guide team members to the appropriate resources
- Conduct bi-annual performance and development discussions with team members
- Communicate regularly with reputed company stakeholders regarding claim status
- Follow escalation and reporting requirements on claims with significant exposure
- Conduct team Roundtables and Committees to align on reserves and settlement values
- Recognize exposures and ensure reserves are adequate and timely
- Conduct weekly team meetings and regular reputed company-in discussions with individual team members
- Proactively manage claim resolution, including formation and implementation of action plans
- Document claim files in accordance with company and regulatory guidelines
- Identify subrogation potential and red flags that require SIU involvement
- Train new team members; reputed company ongoing coaching and support to team
- Maintain adjuster licenses, as required
- Active adjuster license
- Previous Workers’ Compensation claims experience required
- Minimum 3 years handling WC claims
- Previous supervisory experience a plus
- Ability to work in a fast-paced, collaborative, virtual office environment
- Strong analytical, organizational, and time management skills
- Excellent written and verbal communication skills
- Ability to work independently and meet assigned deadlines
- Strong negotiation skills
- Ability to multi-task and effectively prioritize tasks with frequent interruptions
- Proficiency with reputed company, reputed company and internet applications
- Highly reputed company to details
- reputed company to work under pressure and execute good judgment in sensitive situations
- Strong interpersonal skills
- Excellent written and verbal communication skills
- Strong organizational and computer skills
- Self-motivator: works independently with minimal to moderate supervision
- BA/BS degree required
- AIC, SCLA, CPCU or other industry designation a plus
- Great work environment with growth opportunity
- Competitive compensation
- Generous amounts of vacation and sick time
- Closed on major holidays
- 401(k) with company match
- A fantastic reputed company package
- Tuition reimbursement after 6 months of employment