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Claims Representative - Workers Compensation
Claims Representative - Workers CompensationImagine Staffing Technology • Austin, TX, US
Claims Representative - Workers Compensation

Claims Representative - Workers Compensation

Imagine Staffing Technology • Austin, TX, US
2 days ago
Job type
  • Full-time
Job description

Job Description

Job Description

Job Title : Claims Representative – Workers Compensation

Location : Phoenix, AZ

Hire Type : Contingent (assignment tentatively scheduled for 3 months)

Pay Range : $40 - $44 / hour

Work Type : Full-time

Work Model : Remote for candidates with both CO & AZ experience

Work Schedule : Monday – Friday, 8am – 5pm

Nature & Scope : Positional Overview

The Imagine Group is recruiting for a Claims Representative – Workers Compensation on behalf of our client, a leading provider of technology-enabled risk, benefits and integrated business solutions, specializing in claims management and supporting services across multiples industries in Phoenix, AZ .

In this role, you will be responsible for managing workers’ compensation claims from initial report throughout resolution, ensuring compliance with all applicable regulations and company standards. You will investigate claims, evaluate medical and employment information, and coordinate communication between injured employees, employers and medical providers.

Role & Responsibility :

Tasks That Will Lead to Your Success

  • Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and flies necessary documentation with state agency.
  • Develops and coordinates low level workers compensation claims’ action plans to resolution, return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
  • Administers subrogation of claims and negotiates settlements.
  • Communicates claim action with claimant and client.
  • Ensure claim action with claimant and client.
  • May process low-level lifetime medical and / or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintains processional client relationships.
  • Performs other duties as assigned.
  • Supports the organization’s quality program(s).
  • Travel as required.

Skills & Experience

Qualifications That Will Help You Thrive

  • Bachelor's degree from an accredited college or university preferred.
  • Colorado WC jurisdiction proficiency / AZ licensing or certification is a plus.
  • Two (2) years or more direct WC claim handling.
  • Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
  • Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business.
  • Excellent oral and written communication, including presentation skills.
  • PC literate, including Microsoft Office products.
  • Analytical and interpretive skills.
  • Strong organizational skills.
  • Good interpersonal skills.
  • Ability to work in a team environment.
  • Ability to meet or exceed Service expectations.
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