Claims processor Jobs in Rochester, NY

Top regional insurance company is seeking a workers compensationclaims assistant for its office inSpring Valley NY.

What you will be doing :

• Conduct initial loss investigations on low and midlevel workers compensation claims to determine compensability under close supervision.
• Establish initial and subsequent reserves to ensure reserves are adequate for anticipated exposure with increasing degrees of responsibility and complexity.
• Review and approve medical bills for causal relationships to reported claims.
• Liaise with insureds nurse case managers and counsel to oversee the management of claims and facilitate full or transitional duty return to work.
• Manage EDI and other claims coding functions along with data entry and report generation.
• Respond to inquiries and requests for information from insureds brokers medical providers and other external parties.
• Prepare and present claim review summaries for insureds brokers and internal contacts as requested.
• Participate in roundtable discussions with internal colleagues insureds and counsel on strategies for successful claim closures / resolutions.
• Support other members of the claims department with larger or more complex claims as assigned.
• Assist in the insured onboarding process including training on claims reporting and the use of the insured portal.

Experience you will need :

Top Reasons to Work with our client

Key Skills

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Employment Type : Full Time

Vacancy : 1