WC Claims Technician
About The Position
As the Worker’s Compensation Claims Technician, you will provide courteous and professional customer service to the Workers’ Compensation members and member employees in the investigation and handling of medical only workers’ compensation claims in a prompt and timely manner. The employee will have extensive direct phone contact with Workers Compensation Fund participants, injured employees, and third-party vendors. Work also includes explanation of claim processing procedures, as well as answering basic questions regarding Workers’ Compensation coverage. Work is performed under the overall direction of the Claims Manager and Assistant Claims Manager. The Workers Compensation Supervisor provides daily oversight subject to review through audit, reports, and observation.
Requirements
- High school diploma or equivalent.
- Exhibit a professional manner in dealing with others and works to maintain constructive working relationships at all levels within MMA, as well as with members of the association.
- Strong customer service skills desired including dispute resolution and time management skills.
- Familiarity with computers and Microsoft Office applications.
- Ability to make a variety of determinations and computations accurately.
- Ability to deal with the public and employees professionally and tactfully.
- Ability to convey precisely and accurately the information required for prompt handling of claims.
- Ability to establish and maintain good working relationships with internal staff, municipal representatives, and service providers.
- Strong organizational skills and ability to establish priorities.
Nice To Haves
- Experience in insurance, preferably claims, with an emphasis on workers’ compensation is preferred but not required.
Responsibilities
- Maintain assigned claim files through investigation, processing, and payment of "no lost time" and "close-end lost time" claims in a timely manner.
- Communicate with other RMS departments, members, and medical personnel regarding specific claims activity.
- Maintain current and accurate diaries on a daily basis.
- Conduct timely review and payment of medical bills.
- When necessary, meet with participating members and injured employees to assist in the resolution of claims.
- Work file for subrogation and restitution recovery when applicable.
- Clearly explain the Workers’ Compensation Law as it relates to a particular claim.
- Maintain a thorough knowledge of the Workers’ Compensation Act as it relates to medical only claims.
- Present facts effectively, orally and in writing.
- Maintain a thorough knowledge of the claims processing procedure.
- Document claim activity.
- Establish and maintain effective internal and external working relationships.
- Work independently within established guidelines.
- General working knowledge of computers, ability to work with current Claims operating system.
- Maintain a thorough knowledge of the MMA's Workers’ Compensation Fund.
- General knowledge of the concepts of risk management and loss control.
- Familiar with various types of programs provided by the MMA.
- Provide accurate and timely reporting to Medicare.
Benefits
- 100% employer‑paid health and dental insurance for full‑time employees.
- Employer retirement contributions up to 10%, supporting your long‑term financial well‑being.
- Generous paid vacation, sick leave, and holidays, promoting strong work‑life balance.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
