Date Posted: 09/27/2024
Hiring Organization: Rose International
Position Number: 471915
Job Title: Claims Associate - Workers Compensation
Job Location: Remote, USA
Work Model: Remote
Employment Type: Temporary
Estimated Duration (In Weeks): 4
Min Hourly Rate($): 45.00
Max Hourly Rate($): 45.00
Must Have Skills/Attributes: Analytical Skills, Claims, Computer Literacy, Worker
Job Description
:
• To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and coordinates low level workers compensation claims'' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
• Administers subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
• Performs other duties as assigned.
• Supports the organization''s quality program(s).
• Travels as required.
QUALIFICATIONS
Education & Licensing
• Bachelor''s degree from an accredited college or university preferred.
Experience
• Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
Skills & Knowledge
• Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Service Expectations - **Only those lawfully authorized to work in the designated country associated with the position will be considered.**
- **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**
Benefits:
For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website.
California Pay Equity:
For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.
Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.
If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department.
Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).
Thanks for the opportunity. If in the future I ever need a job, I would like to work for Rose International.
David, Consultant
I had a very positive experience working for Rose. The entire process is very efficient and easy.
Joanne, Consultant
Each time I contacted Rose, I was completely satisfied with the great attention and customer service I received. Each person was extremely knowledgeable and patient with my concerns or questions.
Diana, Consultant
Rose International maintained good communication during assignments and are very informative through email and phone calls.
Sade, Consultant
As a contractor, I have to say that Rose International was by far the best agency I have worked for.
Q'testdalir, Consultant
EMPLOYEE COMMENTS