Claims Specialist
- Receives claims, confirms policy coverage and acknowledgment of the claim
- Determines validity and compensability of the claim
- Establishes reserves and authorizes payments within reserving authority limits
- Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision
- Communicates claim status with the customer, claimant and client
- Adheres to client and carrier guidelines and participates in claims review as needed
- Assists other claims professionals with more complex or problematic claims as necessary
- Requires regular and consistent attendance
- Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (“IIPP”)
- Additional projects and duties as assigned
- Excellent written and verbal communication skills
- Ability to learn rapidly to develop knowledge and understanding of claims practice
- Ability to identify, analyze and solve problems
- Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets
- Strong interpersonal, time management and organizational skills
- Ability to meet or exceed performance competencies
- Ability to work both independently and within a team environment
- Bachelor's degree or a combination of education and related experience
- Minimum of 1 year of industry experience and claims management preferred
- State Certification as an Experienced Examiner
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