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Primary Purpose Resolves complex Workers Compensation claims, based on the Supervisors discretion, by investigating, negotiating, and settling claims; conducting ...
We're looking for an experienced Worker's Compensation Claims professional to join our claims team that handles Wisconsin and Indiana claims. At least 3 years ...
Primary Purpose Accomplishes the WC claims objectives by leading, directing, and mentoring the WC claims staff; providing claims and administrative support ...
For your reference, we have included the original job posting below.
Workers' Compensation Claims Inter
Job Number:
42806160
Company Name:
Society Insurance
Job Location:
Fond Du Lac, WI US
Job Category:
Insurance
Minimum Education:
High School Diploma
Workers' Compensation Claims Inter
Primary Purpose
Supports the Workers Compensation Claims department by developing technical knowledge of the department; executing job shadows; completing assigned projects in accordance with departmental and company guidelines and standards.
Essential Functions and Responsibilities
(Other duties may be assigned)
Maintains WC databases accuracy by entering new and updated claims information, Tax ID numbers, referrals and mailing addresses; updating Approach and ISO Indexing databases.
Produces and manages information by generating, copying, printing, transmitting, and distributing letters, forms, files, reports, EDI (Electronic Data Imaging) data and other pertinent documentation for claims files to and/or for appropriate contact.
Initiates new claims by verifying coverages; entering information into Q&A, PCA and UCM programs; distributing claims to appropriate staff member.
Manages check payment process by posting manual drafts in PCA; voiding drafts; issuing stop payments, loss and expense checks.
Develops knowledge of workers compensation system by reviewing Workers Compensation Handbook and attending claim investigations and workers compensation hearings.
Reviews cost containment methods (utilization reviews, independent medical exams, and record reviews).
Prepares various reports by researching, collecting, analyzing, and summarizing research and project data.
Participates in a variety of functions in Marketing, Underwriting and Property/Auto/Liability departments by observing and/or assisting with claim investigation, department meetings, workers compensation hearings, mediation, agency visits, trade show attendance, etc.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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