Claims Assistant, Workers' Compensation

BETA HEALTHCARE GROUP RISK MANAGEMENT•Roseville, CA

5d•$27 - $30•Hybrid

About The Position

Our Claims team is looking for a new Claims Assistant to add to our Workers’ Compensation team! We are a fun, fast-paced team who work hard for our members. Are you organized and can communicate effectively with members? Do you do well under pressure and changing priorities? Do you like working in a collaborative team environment? Do you have a track record of anticipating problems, evaluating and making good decisions? Are you interested in expanding your career in Workers' Compensation Claims Management? If so, our team is looking for you! ABOUT BETA HEALTHCARE GROUP: BETA Healthcare Group (BETA) is the largest professional liability insurer of hospitals on the west coast, providing coverage to more than 600 hospitals and healthcare facilities and provides workers' compensation coverage for over 90,000 healthcare workers in California. BETA also has a long-established and growing commitment to physicians, providing medical professional liability coverage to nearly 7,700 physicians and more than 70 medical groups. Beyond primary liability and workers’ compensation coverage, BETA provides an entire suite of alternative risk and insurance services, including excess healthcare professional liability coverage, excess workers’ compensation coverage, third-party claims administration services, risk management consulting services and claims management consulting services. Whether with hospitals, medical groups, clinics or hospices, BETA has earned a reputation for financial strength, rate stability, quality service and breadth of coverage that is unparalleled in the industry. ABOUT THE ROLE: In this role, you will assist claims examiners in the administration of Workers’ Compensation Claims for our members. This position will allow working from home up to 2 days a week and must be located a commutable distance to the Granite Bay office.

Requirements

High school diploma or G.E.D. required.
Minimum of one (1) year experience as a Claims Clerk, Claims Assistant, or similar role preferred
General knowledge of basic W.C.
Passed the I.E.A. or The Institutes CA 10 and medical terminology course preferred
Strong organizational and multi-tasking skills
Solve problems and properly calculate benefits using mathematics; identify appropriate solutions using logic and reasoning
Gather facts using verbal, non-verbal (active listening) and other human relations skills
Manage multiple simultaneous projects; working independently in a multi-tasking office setting
Basic computer skills required to complete assigned tasks within claims system, Excel, Word, and other standard office programs and be able to learn and implement specialty software systems and procedures
Be responsible for protection of patron confidentiality
Handle multiple activities or interruptions at once and to work positively and effectively within a team or self-directed model
Work with keen attention to detail and accuracy

Nice To Haves

General knowledge of basic W.C.
Passed the I.E.A. or The Institutes CA 10 and medical terminology course preferred

Responsibilities

Paying benefits
Processes payments
Call treating physician for work status update
Call employer for determination of mod-duty / RTW status and potential Wage-Loss
Complete wage loss calculation within 14 days of receipt and document in claims system
Calculate wage statements within 14 days of receipt and make necessary adjustments to pay rate as needed
Maintain ongoing diary system for timely benefit payments
Update notepads with each payment made
Set up (per examiner) and monitor autopay system
Claim Processing
Complete 2-point contact on assigned indemnity claims (to include ER and physician contact)
Call physician for employee medical status, as appropriate
Record detailed summary of injury and all facts/details of loss in “accident info” notepad
May send defense attorney referrals with appropriate records
Send WCAB settlement packages according to their guidelines
Set appointment for injured workers as needed
Send permanent and stationary reports along with all necessary information to disability evaluation unit for permanent disability rating
Copy work for clerical support as needed and reinsurance as needed
Pay mileage and Rx reimbursements
Subpoena records, as instructed
May prepare and mail objection notices to vendors, etc.
Maintain diary and mail currency according to company standards
Respond to email and/or telephonic inquiries according to company policies
Provide courteous and professional service
Complete time sheet reflecting accurate hours worked each day
Reports for work on time and maintains a satisfactory attendance record
Other duties as assigned