Claims Associate - Workers Compensation (Med Only) - Remote

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?   

• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.  

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.  

• Enjoy flexibility and autonomy in your daily work, your location, and your career path.   

• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.  

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ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.  

PRIMARY PURPOSE OF THE ROLE  To analyze medical only claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. 

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships; Performs other duties as assigned; Supports the organization's quality program(s).

QUALIFICATIONS 

Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. 

Experience: One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

Licensing / Jurisdiction Knowledge: 

TAKING CARE OF YOU  

• Flexible work schedule.  

• Referral incentive program.  

• Opportunity to work in an agile environment. 

• Career development and promotional growth opportunities.  

• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. 

WORK ENVIRONMENT REQUIREMENTS INCLUDE  
When applicable and appropriate, consideration will be given to reasonable accommodations.