13 Jobs in SeaTac, WA
NESCO Resource is Hiring a Claims Representative - Workers Compensation Near SeaTac, WA
Location: Remote
Certification: WA or OR certification
Years of Experience: 1
DescriptionPRIMARY PURPOSE: 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.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
- Bachelor's degree from an accredited college or university preferred.
- Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.
- 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.
Job Summary
Full Time
$80k-102k (estimate)
06/06/2024
07/04/2024
nescoresource.com
Cleveland, OH
1,000 - 3,000
Related Companies
The following is the career advancement route for Claims Representative - Workers Compensation positions, which can be used as a reference in future career path planning. As a Claims Representative - Workers Compensation, it can be promoted into senior positions as a Workers' Compensation Administrator III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Representative - Workers Compensation. You can explore the career advancement for a Claims Representative - Workers Compensation below and select your interested title to get hiring information.
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