Workers' Compensation Claims Examiner
Amergis Healthcare StaffingColumbia, MD, US20 hours ago
Job type
- Full-time
Job descriptionAt least two (2) years of Workers' Compensation experience preferred Some legal or insurance claims experience strongly preferred College degree preferred; work experience will be considered Good organizational skills and attention to detail Ability to work independently and cooperatively in a team environment Ability to effectively elicit / provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, clients) via strong communication skills required; proficiency in the English language is required Proficiency with Microsoft Office applications Prior experience performing internet research
Claims Examiner Workers' Comp I
The Claims Examiner Workers' Comp I monitors claims and makes decisions on reserve adjustments, plans of action, and closure of non-litigated claims.
Essential Duties and Responsibilities :
- Handles new Workers' Compensation claims to resolution
- Participates in conference calls with local offices, third-party administrators (TPAs), medical providers, and other Amergis employees to communicate status plans
- Monitors TPA's file resolution plans
- Controls all financial aspects of assigned claims files, including reserves per the TPA service agreement in consultation with the WC Manager
- Coordinates claims with Claims Examiner III or designee in the event of litigation
- Monitors lost time and transitional duty opportunities
- Escalate reserve requests to Claims Examiner III or designee
- Coordinates with Benefits during employee's absence
- Coordinates with state programs and internal departments for transitional duty
- Educates branch offices about all aspects of Workers' Compensation
- Assists Workers' Compensation Manager in achieving overall department goals
- Performs other duties as assigned / necessary
Minimum Requirements :
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Claim Examiner • Columbia, MD, US