Remote Workers Compensation Claims Representative
Adecco is currently assisting a local client in their search to fill a Remote Workers Compensation Claims Representative position with experience in both Colorado and Arizona states. Pay Rate : $40.00 / HR Shift : Mon Fri 8am 4 : 30pm
PRIMARY PURPOSE :
- To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
Job Description :
Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files 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.Ensures claim files are properly documented and claims coding is correct.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 professional client relationships.Performs other duties as assigned.Supports the organization's quality program(s).Travels as required.Minimum Qualifications :
Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.Any specific skill / certification / license : Colorado WC jurisdiction proficiency / AZ lisc. or certification is a plus. Bachelor's degree from an accredited college or university preferred.Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of businessExcellent oral and written communication, including presentation skillsPC literate, including Microsoft Office productsAnalytical and interpretive skillsStrong organizational skillsGood interpersonal skillsAbility to work in a team environmentAbility to meet or exceed Service ExpectationsWhen applicable and appropriate, consideration will be given to reasonable accommodations.Apply Today to be considered for this Remote Workers Compensation Claims Representative job and any other positions with Adecco.
Pay Details : $40.00 per hour Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer / Veterans / Disabled