Specialist - WC Claims Support

Principal Purpose of Position :

Assisting with maintenance of the drug Screen list.

Direct Handling of “non-complex” claims.

Uploading into RK and maintaining the electronic files upon request from the WC team.

Pulling the Concentra notes daily, distributing them and posting to the file

Communicating the reserve changes as received

Pulling the new FROIs and saving to RK (Riskonnect RIMS system)

Claim Reviews : Managing the list, the schedule and distributing updates. Ensuring a smooth process.

Adding the Carrier Claim Review summaries to RK.

Ordering / Managing referrals : mainly for social media checks and med canvasses. Once the med canvass is in, evaluating the “hits”, communicating that to Liberty and following up for the receipt and status of the records.

Assisting with medical record review and summaries for the team.

Reporting claims to Pinnacol / SAIF, Washington, Amtrust and Ohio.

Payroll Requests : Requesting wages and transposing onto the appropriate form.

For employees on partial benefits, obtaining wages on a biweekly basis, evaluating them and sending them to the adjuster to pay partial. Setting a diary to be on top of this.

Requesting updates from Leaves department on open cases.

Following up on any open subrogation cases.

Pulling pre-hire physicals out the system and saving to RK

Keeping the Approved Clinic List, and preferred doctor list current in RK.

Assisting Team with clinic check ins tied to both post-accident and pre-hire physicals.

Billing Issues : When outstanding bills are presented by an employee, calling the provider and providing the correct billing info so that WC is billed.

Handling the WC postings with Oti and Kaitlyn.

Managing the Chain of Custody forms. Making sure we have a supply, stamping them, sending them out to the location upon request and keeping a spreadsheet of when and where they are sent.

Directly handling some of the backup clinic check ins - on a yearly basis.

Assist Meghan with updating our forms in Nitro.

Pull loss runs and update RK with the reserves on non-Liberty cases.

Perform all other duties and special projects as assigned.

Education and / or Training :

High school diploma required. Four-year college degree or demonstrated equivalent experience as determined by department management preferred but not required.

Relevant Work Experience :

2 years workers’ compensation claims management experience.

AIC, CPCU or SCLA certifications preferred or ability to obtain.

Planning / Organizing / Managerial Knowledge :

Understanding of applicable statutes and regulations.

Advanced knowledge of MS applications especially Word, Excel, PowerPoint.

Knowledge of Zoom and Microsoft Teams.

Demonstrate ability to solve problems and operate in a fast paced, multi-task environment independently.

Ability to organize and prioritize tasks and make appropriate decisions on a daily basis.

Adapts department plans and priorities to address business and operational challenges.

Experience with a Risk Management Information System (RMIS) a plus.

Communicating & Influencing Skills :

Strong verbal and written communication skills. Ability to communicate effectively with colleagues in various departments and geographical locations, including all levels of management as well as employees.

Ability to prioritize, organize and direct multiple internal and external team players towards a common plan of action and ensure the plan is executed.

Physical requirements :

Requires working primarily in office setting – standing, sitting, walking, bending, twisting and stooping.

Local travel to assist specialists and safety with accident investigations is possible.

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