Reports directly to the Claims Supervisor. Candidate is responsible for effectively managing assigned claims files to conclusion, in accordance with applicable statutes and in keeping with company procedures and established performance objectives.
To perform this job successfully, an individual must be able to perform each essential duty well. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Bachelor's degree from four-year college.
Essential Duties and Responsibilities:
Perform a three-point contact (claimant, employer, and treating physician) on all new losses within 24 hours of receipt of the claim, to document relevant facts surrounding the incident itself as well as disability and treatment status.
- Thoroughly and accurately gather evidence regarding ongoing case facts and relevant information necessary for establishing compensability. Determine the need for disability payments, the use of vendors, medical and expense payments, and the reason the claim is still open.
- Assure that all assigned indemnity claims have an up to date action plan outlining activities and actions anticipated for ultimately resolving the claim.
- Form a partnership with the medical case manager to maximize early return to work.
- Aggressively pursue subrogation from culpable third parties.
- Assure that the claim file is handled totally in accordance with applicable statutes.
- Establish, monitor, and adjust monetary case reserves when warranted and in accordance with assigned authority levels.
- Review all medical bills for appropriateness.
- Exhibit and maintain a courteous attitude and project a professional image on behalf of the company.
- Respond to telephone messages and inquiries within 24 hours of receipt.
To perform the job successfully, an individual should demonstrate the following competencies:
- Problem Solving- Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics.
- Customer Service - Manages difficult or emotional customer situations; Responds to requests for service and assistance; Responds promptly to customer needs; Meets commitments.
- Interpersonal- Remains open to others' ideas and tries better ways. Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control.
- Team Work - Supports everyone's efforts to succeed.
- If you have read the entire job posting, please put down code word "gosynergy" in your cover letter.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Ability to calculate figures and amounts.
Ability to solve practical problems and deal with a variety of concrete variables. Ability to interpret a variety of instructions in various forms.
To perform this job successfully, an individual should have knowledge of Word Processing software; Spreadsheet Software and Database Software.
$30,000+ salary to start based on experience and bonus potential. Ability to see double digit salary percentage increases with performance.
Full-time including comprehensive benefits package. We offer an excellent work environment, a "Wellness Program" with free membership to local recreation center, a full range of benefits, including medical, 401K, and vacation.