Medical Only Claims Examiner

. Primary Duties 

• Investigate claims thoroughly, including coverage and identifying subrogation.
• Manage medical issues and schedule timely appointments.
• Work closely with Team Manager to identify red flags.  
• Consistently keep claim files documented and updated 
• Ensure that all medical payments are issued timely and appropriately.  

Requirements  

• Successfully pass tests in states where they are required for license
• Complete required ongoing education credits to maintain license
• Attend training and become proficient with workers’ compensation statutes for the states that you have been assigned
• Strong oral and written communication skills
• Strong analytical skills and attention to detail
• Time management skills and demonstrated ability to manage multiple priorities with accuracy and efficiency
• Ability to provide professional and friendly customer service
• Proficient knowledge of Microsoft Office suite

Skills & Knowledge

• Excellent oral and written communication
• PC literate, including Microsoft Office products
• Strong organizational skills
• Efficient time management skills
• Ability to work in a team environment
• Strong interpersonal and skills
• Ability to meet or exceed Performance Competencies
• Can determine what next steps are required and proactively respond
• Able to multi task in various systems and/or programs

Competencies

Thoroughness. Technical Capacity. Problem Solving. Customer Service Oriented Teamwork Interpersonal and leadership

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

Position Type/Expected Hours of Work

This is a full-time position. Standard days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m. Based on business needs this may change.   

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status.  California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at www.Acrisure.com/privacy/caapplicant.
 

To Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisure’s property, and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisure’s Human Resources Talent Department.