What are the responsibilities and job description for the Workers Compensation Representative position at Commercial Risk Management, Inc?
Job Overview
To manage suspense of medical only workers’ compensation claims for specific self insured employers, while adhering to Commercial Risk Management, Inc.’s Best Practices. To direct medical treatment and communicate with injured workers, employers and providers, while maintaining exceptional customer service in all aspects of claims management.
Essential Job Duties:
· Review, examine, and analyze routine workers’ compensation claims.
· Make sound decision regarding the compensability of claim, being mindful of specific instructions and authority provided by each self insured client.
· Interact with injured workers to ensure awareness and understanding of the workers’ compensation process, requirements and entitlements.
· Establish claim reserve levels by estimating the cost of each assigned claim; monitor reserves and update amounts as necessary and pursuant to CRM Best Practices.
· Coordinate medical treatment for injured workers and provide information to treating physicians regarding employee’s medical history, health issues and job requirements.
· Monitor medical reports and be able to identify conditions/treatment that are outside the realm of compensability and effectively communicate with the medical provider regarding causal relation and major contributing cause.
· Review medical bills and reports for appropriateness and authorize for timely payment.
· Review prescription bills and requests for authorization of prescriptions for appropriateness and timely payment.
· Identify subrogation potential and pursue the process of reimbursement.
SALARY & BENEFITS: Low stress office in the Westshore district with office hours of 8:30 to 4:30. Salary is negotiable. Group health, dental, life insurance, long term disability, 401k, vacation and stress days are available as well as the ability to work from home.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Physical Setting:
- Office
Schedule:
- Monday to Friday
Supplemental Pay:
- Bonus pay
Job Type: Full-time
Expected hours: 35 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Ability to Commute:
- Tampa, FL 33609 (Required)
Ability to Relocate:
- Tampa, FL 33609: Relocate before starting work (Required)
Work Location: In person