Customer Service Representative

Summary:

This worker will be assisting Lost Time Examiners with benefit notices, settlement documents, requesting records, and indemnity payments.

Job Description

• :When necessary, help the examiner make appropriate compensability decisions by assisting with contacts
• .Ensure the completion of delegated tasks by maintaining active file diaries
• .Understand jurisdictional benefit rates and payment deadlines to ensure compliance with state timeframes
• .Accurate documentation of claim activity is within the file notes
• .Produce quality documentation in an accurate and timely manner, i.e., benefit notices, nurse and legal referrals, record requests, and settlement documents
• .Respond timely and appropriately to internal and external customers on claim-related issues
• .Adhere to state regulations for AZ, CA, CO, and UT
• .Manage an inventory of direct-handle pension and/or lifetime medical files
• .Collaborate with peers in the Region to ensure adequate coverage during vacations or absences
• .Adhere to Best Practice guidelines
• .Collaborate with appropriate resources to timely resolve issues

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Technical Skil

• ls3 years of customer service showcasing verbal, written, and interpersonal skill
• s.In sending state notices there must be an aptitude for evaluating, analyzing, and interpreting informatio
• n.Adaptability to constantly evolving environments and demonstrable flexibility that meets or exceeds a state requirement or a customer’s expectatio
• n.Ability to work independently and efficiently while performing defined functions with minimal error
• s.1 years’ experience with basic understanding of the Workers’ Compensation and claim handling processe
• s.Proficient computer skills and extensive knowledge of the Microsoft suite of Office products, including Outlook (use templates that are provided), Word (utilizing templates), Excel (data entry), and PowerPoint (basic creation of slide deck); knowledge of state EDI systems and/or familiarity with CA Workers Compensation terminology are a plu
• s.Effective time management skills demonstrate the ability to multi-task and prioritize by accomplishing tasks and assignment

s.
Education/Experien

• ce:Minimum high school degree, associate degree prefer
• redPrior clerical and technical experience in researching and indexing data is preferred but not requir
• ed.Proficiency in using Microsoft Office Produ
• cts3 years of customer service showcasing verbal, written, and interpersonal skil
• ls.1 years’ experience with basic understanding of the Workers’ Compensation and claim handling process
• es.Experience in a fast-paced, fluid environm
• entStrong communication and telephonic ski
• llsKnowledge of medical terminology is a plus but not requir
• ed.Knowledge of bill processing is a plus but not requir
• ed.Knowledge of claim handling is a plus but not requir