Workers Compensation Claims Assistant

Workers Compensation Claims Assistant

Job Details

Job Type

Full-time

Rocklin, CA

Description

Summary :

Reports directly to the unit Claims Supervisor but takes primary direction for the assigned Claims Specialist(s). Responsible for providing clerical operations support to assigned Claims Specialist(s).

Essential Duties and Responsibilities :

Prepares new claims files

Calculates TTD, Wage Loss, VRMA and PD benefits

Issues compensation payments on diary schedule

Issues Benefit Notices

Doctor status calls and Employee / Employer contact calls

Employer contact calls to confirm light duty / modifies work

Works closely with Claims Specialist to complete clerical assignments

Prepares litigation documents such as C&R, Stipulations, Answers, etc

Prepares rehabilitation forms for filing with the rehabilitation unit

Handle calls from providers inquiring about unpaid bills and bill related questions

Review Mail and process direct pays bills such as Mileage Reimbursement

File and Serve duties (as needed)

Notepad documentation in Portal

Requirements

Competency :

To perform the job successfully, an individual should demonstrate the following competencies :

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations.

Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.

Team Work - Supports everyone's efforts to succeed.

Qualification Requirements :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and / or Experience :

High school diploma or general education degree (GED); or 1-2 years related experience and / or training; or equivalent combination of education and experience.