Workers' Compensation insurance deals with companies and their employees. This position requires someone who enjoys a challenge, can handle complicated situations and feels fulfilled helping people get healthy after being injured. You will be investigating claims, determining if the claim is payable and managing the care of the injured employee.
- Ability to solve practical problems and to work independently.
- Good interpersonal skills.
- Fluent English is required. Spanish speaking is a plus.
- Ability to build and maintain relationships with insureds, injured workers and attorneys.
- Ability to develop and display resourcefulness.
The position involves:
- Determining coverage on new claims.
- Contacting employer for initial investigation.
- Contacting employee/injured worker for information – recorded statements
- Reviewing medical bills to determine if payment is proper and referral of those bills for audit.
- Filing necessary forms with the Industrial Commission.
- Determining appropriate reserves for claims.
- Determining when claims need medical case management services and arranging the necessary care.
- Corresponding with attorneys on legal issues.
- Attending mediations and hearings.