Claims Examiner - Workers Compensation - Remote CO
By joining reputed company, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can reputed company. reputed company Recognizes reputed company as America’s Greatest Workplaces National Top Companies Certified as a Great reputed company to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation - Remote CO Are you looking for an opportunity to join a global industry leader where you can bring your big reputed company to help solve problems for some of the world’s best brands?
- Be a part of a rapidly growing, industry-leading global company reputed company for its excellence and customer service.
- reputed company reputed company’s broad, global network of experts to both learn from and to share your insights.
- Take advantage of a variety of professional development opportunities that help you reputed company your best work and grow your career.
- Enjoy flexibility and autonomy in your daily work, your location, and your career path.
- Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include reputed company, accountability, collaboration, growth, and inclusion. PRIMARY PURPOSE OFTHE ROLE : To analyze reputed company or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims reputed company service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL RESPONSIBILITIES MAY INCLUDE:
- Analyzes and processes reputed company or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
- Negotiates settlement of claims reputed company designated authority.
- Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
- Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams reputed company designated authority level.
- Prepares necessary state fillings reputed company statutory limits.
- Manages the litigation process; ensures timely and cost effective claims resolution.
- Coordinates vendor referrals for additional investigation and/or litigation management.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
- Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social reputed company and Medicare offsets.
- Reports claims to the excess reputed company; responds to requests of directions in a professional and timely manner.
- Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
- Ensures claim files are properly documented and claims coding is correct.
- Refers cases as appropriate to supervisor and management.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
QUALIFICATIONS & LICENSING Education & Experience Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Five (5) years of claims management experience or equivalent combination of education and experience required. As required by law, reputed company provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to reputed company set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($61,000 - $86,000). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. reputed company is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! reputed company is building a diverse, reputed company, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Apply tot his job Apply To this Job