Workers Compensation Claims Support Specialist

Advocate Health and Hospitals Corporation • Wake Forest, NC

3d • $21 - $32

About The Position

The Workers Compensation Claims Support Spec provides support and backup for the administration of workers' compensation claims for the organization. This position requires critical thinking and excellent customer service. The Claims Administration Support will have considerable phone interaction with both internal and external stakeholders, leadership, and the WC Team. Consistently being at work and timely, is inherently required of this position.

Requirements

• High School diploma required; Bachelor's degree a plus.
• One or more years of Workers' Compensation and/or Liability claims support or handling experience, customer service or generalclerical experience.
• Must be able to prioritize work.
• Must work with a sense of urgency and accuracy.
• Must be able to work independently and with a team.
• Must have familiarity with medical terminology.
• Must be able to manage multiple tasks simultaneously, make difficult decisions and focus on details.
• Must have excellent verbal and written communication skills.
• Must be proficient in Microsoft Office products.
• Limited access to protected health information (PHI) to the information necessary to do the job.
• Sharing of information only on a need-to-know basis for work purposes.

Nice To Haves

• Bachelor's degree a plus.

Responsibilities

• Must possess analytical skills and be able to work with a sense of urgency and accuracy.
• Must remain highly engaged and efficient supporting the Workers' Compensation Team within the standard of work guidelines.
• Must be able to monitor the Workers' Compensation phone line; return calls to provide answers, be able to offer guidance and/or support to the Workers Compensation Team.
• Must be able to assign claims to the proper WC Team Member to include sending acknowledgement letters, ISO inquiries, medical authorizations, setting initial reserves and diaries as well as maintain a diary.
• Must be able to monitor and accurately attach incoming medical records, mail/email/faxes to open/closed files.
• Must be able to process tasks/requests as requested by WC Team and other customers; including butnot limited to vendor maintenance in claims administration system, handling check and payment requests, billing issues/inquiries and the resolution of those issues/inquiries and Research returned checks/payment, determine resolution then resend or void payment.
• Must be able to request offsite records and follow-up on outstanding items as needed.
• Must be able to complete required state forms for WC Team upon request.
• Must be able to maintain strict confidentiality of information at all times of a sensitive nature and/or protected under state and federal law.
• Must be able to provide additional support for all other projects and duties as assigned.

Benefits

• Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
• Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
• Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program

What This Job Offers

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