Manage within company best practices lower-level non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional.
ESSENTIAL JOB DUTIES:
Receives claim, confirms policy coverage and acknowledgement of the claim
Determine validity and compensability of the claim
Establish reserves and authorize payments within reserving authority limits
Manage non-complex and non-problematic medical-only claims and minor lost-time workers' compensation claims under close supervision
Communicate claim status with the customer and claimant and client
Adhere to client and carrier guidelines and participate in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Requires regular and consistent attendance.
Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP).
Additional duties as required.
KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills
PC literate, including Microsoft Office (Word, Excel)
Ability to learn rapidly to develop knowledge and understanding of claims practice
Ability to identify, analyze and solve problems
Strong organizational skills
Good interpersonal skills
Ability to work independently
Ability to work in a team environment
Ability to meet or exceed performance competencies
EDUCATION: College degree preferred, work experience can substitute for educational requirement
LICENSES: As required
EXPERIENCE: One (1) year of industry experience and claims management preferred