Claim Technical Assistant
About The Position
When necessary, help the examiner make appropriate compensability decisions by assisting with contacts. Ensure the completion of delegated tasks by maintaining active file diaries. Understand jurisdictional benefit rates and payment deadlines to ensure compliance with state timeframes. Accurate documentation of claim activity is within the file notes. Produce quality documentation in an accurate and timely manner, i.e., benefit notices, nurse and legal referrals, record requests, and settlement documents. Respond timely and appropriately to internal and external customers on claim-related issues. Adhere to state regulations for AZ, CA, CO, and UT. Adhere to Best Practice guidelines. Collaborate with appropriate resources to timely resolve issues. Manage an inventory of direct-handle pension and/or lifetime medical files. Collaborate with peers in the Region to ensure adequate coverage during vacations or absences.
Requirements
- Superior customer service showcasing verbal, written, and interpersonal skills.
- Aptitude for evaluating, analyzing, and interpreting information.
- Effective time management skills demonstrate the ability to multi-task and prioritize.
- Adaptability to constantly evolving environments and demonstrable flexibility.
- Ability to work independently and efficiently while performing defined functions with minimal errors.
- Basic understanding of the Workers’ Compensation and claim handling processes.
- Proficient computer skills and extensive knowledge of the Microsoft suite of Office products, including Outlook, Word, Excel, and PowerPoint.
- If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.
Nice To Haves
- Prior clerical and technical experience in researching and indexing data is preferred but not required.
- Familiarity with CA Workers Compensation terminology are a plus.
- Knowledge of medical terminology is a plus but not required.
- Knowledge of bill processing is a plus but not required.
- Knowledge of claim handling is a plus but not required.
Responsibilities
- Assist with contacts to make appropriate compensability decisions.
- Maintain active file diaries to ensure completion of delegated tasks.
- Understand jurisdictional benefit rates and payment deadlines for compliance.
- Accurately document claim activity in file notes.
- Produce quality documentation, including benefit notices, nurse and legal referrals, record requests, and settlement documents, accurately and timely.
- Respond timely and appropriately to internal and external customers on claim-related issues.
- Adhere to state regulations for AZ, CA, CO, and UT.
- Adhere to Best Practice guidelines.
- Collaborate with appropriate resources to timely resolve issues.
- Manage an inventory of direct-handle pension and/or lifetime medical files.
- Collaborate with peers in the Region to ensure adequate coverage during vacations or absences.
Benefits
- Comprehensive benefits package
- May be eligible to participate in a discretionary annual incentive program.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
