Claims Operations Associate

Berkley•High Point, NC

1d•Onsite

About The Position

Key Risk is looking for an enthusiastic Claims Associate professional who will be responsible for the management of low exposure workers’ compensation claims. The Claims Associate will be responsible for learning workers compensation laws and providing outstanding service to our clients. This is an entry-level position with no experience necessary. Key functions include but are not limited to the following: Maintain good lines of communication with employers, adjusters, and providers Conduct investigation of workers' compensation claims assigned Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only Discuss with an employee, issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued Timely and accurately reserve for claims assigned Document medical notes and relevant written and oral communication received relative to claims in the log notes Discuss with an employer, issues relative to an injured workers’ return to work status Index images as needed Identify potential subrogation claims and notify appropriate supervisor Actively work with mentor and supervisor to develop skills to handle all technical aspects of claims, including coverage, disability benefit management, medical management, litigation management, file management, subrogation, reserving and settlement Maintain and demonstrate knowledge of the Workers' Compensation Act and Rules and Regulations in jurisdictions assigned Immediately notify management of large exposures This position requires the individual to commute to our High Point NC office location.

Requirements

BA/BS Degree
Demonstrate exceptional oral and written communication skills
Demonstrate functional understanding of basic medical terminology
Superior organizational skills and attention to detail
Evidence of self-motivation and requires general supervision
Possess creative problem-solving skills
Ability to manage multiple priorities and coordinate tasks
Complies with state adjuster licensing requirements where applicable. (We allow 6 months to obtain license)
Commitment to increasing knowledge of workers compensation

Responsibilities

Maintain good lines of communication with employers, adjusters, and providers
Conduct investigation of workers' compensation claims assigned
Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only
Discuss with an employee, issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued
Timely and accurately reserve for claims assigned
Document medical notes and relevant written and oral communication received relative to claims in the log notes
Discuss with an employer, issues relative to an injured workers’ return to work status
Index images as needed
Identify potential subrogation claims and notify appropriate supervisor
Actively work with mentor and supervisor to develop skills to handle all technical aspects of claims, including coverage, disability benefit management, medical management, litigation management, file management, subrogation, reserving and settlement
Maintain and demonstrate knowledge of the Workers' Compensation Act and Rules and Regulations in jurisdictions assigned
Immediately notify management of large exposures