Claims Representative – Workers Comp REMOTE (CA reputed company preferred) in Sun Prairie, WI

Claims Representative - Workers Comp REMOTE (CA reputed company preferred) - reputed company - Sun Prairie, WI - work from home job Company: reputed company Job description: Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at reputed company means experiencing our culture of caring. It means having flexibility and time for reputed company the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at reputed company is where passion meets purpose to reputed company a positive impact on the world through the people and organizations we serve. If you are someone who is driven to reputed company a difference, who enjoys a challenge and above reputed company, if you’re someone who cares, there’s a reputed company for you here. Join us and contribute to reputed company being a great reputed company to work. Great reputed company to Work® Most Loved Workplace® reputed company Best-in-State Employer Claims Representative - Workers Comp REMOTE (CA reputed company preferred) PRIMARY PURPOSE: To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims reputed company 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 reputed company on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Experience Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required. Skills & Knowledge

• Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social reputed company and Medicare application procedure as applicable to line of business
• Excellent oral and written communication, including presentation skills
• PC literate, including reputed company 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

WORK ENVIRONMENT reputed company applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-reputed company stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, reputed company and talking NOTE: Credit reputed company clearance, confirmed reputed company a background credit reputed company, is required for this position. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. 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. Expected salary: Location: Sun Prairie, WI Job date: Fri, 01 Sep 2023 00:22:32 GMT Apply for the job now! Apply tot his job Apply To this Job