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Job link: https://ats4.atenterprise.powerschool.com/ats/job_board_form?op=view&JOB_ID=4600296437&COMPANY_ID=JA001160&redirect_qs=&redirect_qs=start_index=100&APPLICANT_TYPE_ID=00000002&COMPANY_ID=JA001160
Capital Region ESD 113 is committed to closing gaps, growing people, influencing change, and eradicating racism through our service to our region and state. BIPOC as well as culturally and linguistically diverse candidates are strongly encouraged to apply.
This position is 8 hours/day and 260 days/year. Benefits include Medical/Dental/Vision, Life/AD&D insurance, FSA/DCAP, LTD insurance, Retirement/DCP, EAP, Annual/Sick Leave and Holiday Pay.
Purpose Statement
The job of Claims Specialist is done for the purpose/s of evaluating eligibility of medical only claims and adjudicating workers' compensation claims in compliance with state RCW and WAC regulations; conveying information regarding medical claims and benefits; supporting loss control services in participating school districts; documenting actions; and providing program support and services consistent with internal practices and procedures.
This job is distinguished from similar jobs by the following characteristics: Per the essential functions and educational requirements listed below.
This job reports to Director - Risk Management or Claims Administrator
Essential Functions
Marginal Functions
Job Requirements: Minimum Qualifications
Skills, Knowledge and Abililities
SKILLS are required to perform single, technical tasks with a need to occasionally upgrade skills in order to meet changing job conditions. Specific skill based competencies required to satisfactorily perform the functions of the job include: operating standard office equipment; using pertinent software applications; planning and managing case load and special projects; performing standard mathematical calculations; and preparing and maintaining accurate records.
KNOWLEDGE is required to perform basic math, including calculations using fractions, percents, and/or ratios; read a variety of manuals, write documents following prescribed formats, and/or present information to others; and understand complex, multi-step written and oral instructions. Specific knowledge based competencies required to satisfactorily perform the functions of the job include: worker compensation programs; state workers' compensation regulations and laws; medical and legal terminology related to worker's compensation; industrial insurance laws, medical aid rules and fee schedule; and basic anatomy and physiology.
ABILITY is required to schedule a number of activities, meetings, and/or events; often gather, collate, and/or classify data; and consider a variety of factors when using equipment. Flexibility is required to work with others in a wide variety of circumstances; analyze data utilizing defined but different processes; and operate equipment using a variety of processes. Ability is also required to work with a diversity of individuals and/or groups; work with data of varied types and/or purposes; and utilize a variety of types of job-related equipment. Problem solving is required to analyze issues and create action plans. Problem solving with data frequently requires independent interpretation of guidelines; and problem solving with equipment is moderate to significant. Specific ability based competencies required to satisfactorily perform the functions of the job include: communicating with diverse groups; working with frequent interruptions; working with detailed information/data; maintaining confidentiality; establishing effective relationships; adapting to changing work priorities; and thinking critically and executing processes efficiently.
Responsibility
Responsibilities include: working under limited supervision using standardized practices and/or methods; leading, guiding, and/or coordinating others; tracking budget expenditures. Utilization of resources from other work units may be required to perform the job's functions. There is some opportunity to impact the organization’s services.
Work Environment
The usual and customary methods of performing the job's functions require the following physical demands: occasional lifting, carrying, pushing, and/or pulling, some stooping, kneeling, crouching, and/or crawling and significant fine finger dexterity. Generally the job requires 70% sitting, 20% walking, and 10% standing. This job is performed in a generally clean and healthy environment.
Experience: Job related experience with increasing levels of responsibilities is required.
Education (Minimum): High school diploma or equivalent
Equivalency: None specified
Required Testing
None specified
Certificates and Licenses
Valid driver’s license & insurance coverage as required by law
WA State Self Insurance Certification at the time of hire or enrollment in a comprehensive goal-orientated curriculum within 90 days; achieve certification within two years from hire date
Continuing Educ. / Training
Maintains Certificates and/or Licenses as required and/or needed
Clearances
Criminal Background Clearance
WA State Sexual Misconduct Disclosure Release
FLSA Status
Non Exempt
Job Type: Full-time
Pay: $31.87 - $38.73 per hour
Benefits:
Schedule:
Work setting:
Ability to Relocate:
Work Location: In person
Full Time
$88k-107k (estimate)
04/11/2024
08/08/2024
If you are interested in becoming a Claims Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Claims Specialist job description and responsibilities
The specialist reports and processes these claims by researching the policy and accumulating evidence regarding the claim.
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Claims specialists must also compile reports and communicate regularly with supervisors and managers regarding the status of claims.
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Claims Specialists are responsible for a wide range of administrative tasks related to the delivery of medical care.
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Evaluates liability, coverage and settles claims within prescribed procedures and authority.
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Reviews and evaluates property claims for coverage and further claim handling procedures to conclude within required statutory time frame.
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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Claims Specialist jobs
Claims specialists are required to follow the California Health and Safety Code when accepting or denying claims.
02/04/2022: Lynchburg, VA
They must treat clients fairly and equitably, but also make sure claims are legitimate and reasonable.
03/03/2022: Portland, ME
They must know the details of claims verification, payment processing, dispute resolution and fraud detection.
02/14/2022: Hialeah, FL
A good claims specialist will take a proactive approach to their job.
02/21/2022: Helena, MT
Claims specialist positions require superb organization skills to keep track of financial documents.
03/26/2022: New Bedford, MA
Step 3: View the best colleges and universities for Claims Specialist.