Claims Examiner - Medical Only Workers Compensation

Markel • Omaha, NE

4d

About The Position

This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills.

Requirements

• High school diploma required
• 1-5 years of claims handling or comparable experience required.
• Intermediate Software skills – Microsoft Word, Excel and Outlook
• US Work Authorization required.
• Markel does not provide visa sponsorship for this position, now or in the future.

Nice To Haves

• Ideal candidates will possess experience within the insurance, healthcare, or workers’ compensation industries

Responsibilities

• Investigate medical only claims as reported and determine injured worker’s eligibility for workers’ compensation benefits
• Administers medical benefits for valid workers’ compensation claims
• Manage the progression of the claims process through collaboration with physicians, nurses and other parties as needed
• Determine if subrogation exists and takes the steps necessary to initiate recovery efforts
• All file handling must be within state statutes, client claims handling guidelines, and best practices
• Confirms coverage of claims by reviewing policies and documents submitted in support of claims
• Conducts, coordinates, and directs investigation into loss facts and extent of damages
• Evaluates information on coverage, compensability, and medical management to determine the extent of insured's exposure
• Sets reserves within authority or makes claim recommendations concerning reserve changes to manager
• Focus on driving medical only claims to a resolution/closure
• Prepares reports by collecting and summarizing information
• Adheres to Fair Claims Practices regulations and internal Claims Quality Performance Objectives
• Participates in special projects or assists other team members as requested
• Attend all state specific trainings as scheduled

Benefits

• competitive benefit programs
• multiple health, dental and vision insurance plan options
• optional life, disability, and AD&D insurance
• 401(k) with employer match contributions
• Employee Stock Purchase Plan
• PTO
• corporate holidays
• floating holidays
• parental leave

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED