NV/CLAIMS PROCESSOR-SENIOR
Adecco - Las Vegas, NV

This job posting is no longer available on Adecco. Find similar jobs: Claim Processor Senior jobs - Adecco jobs

Employee will be under minimal supervision, reviews, analyzes, investigates, makes compensability decisions, set appropriate reserves and approves the release of benefit payments up to authorized levels on initial, continued and reopened Nevada workers' compensation claims. Responsible for evaluating new and on-going claims to determine compensability and liability, giving consideration to contract provisions, disability management duration contract guidelines, medical evidence and vocational evidence. Responsible for investigating questionable claims. Determines needs for additional medical information. Responsible for determining appropriate benefit calculations and payments. Performs reviews to verify initial and continued existence of a disabling condition. Responsible for responding to telephone and written inquiries from claimants, attorneys, physicians and policyholders within statutory requirements.
Responsible for identifing and forwarding claims to specialized internal and external resources in areas such as medical exams, rehabilitation, investigations, subrogation and subsequent injury. Responsible for tracking time frames as mandated by statute and regulation. Respond to correspondence to include litigation compliance with decisions & orders. This level is responsible for independently reviewing simple to complex claims for adjudication purposes. Refers more complex claims to higher levels for review and direction.

Must have proof of highest level of education (GED minimum requirement)
Must be able to pass a drug and background screening

About this company
4,470 reviews
Adecco is the world’s largest provider of staffing solutions. But it’s not our size that makes us different, it’s our...