What are the responsibilities and job description for the Workers' Comp Claims Adjuster position at Coventry First?
Coventry
Workers' Comp Claims Adjuster
US-MO-Jefferson City
Job ID : 24-17486
Type : Regular Full-Time
of Openings : 1
Category : Customer Service & Support
Mitchell International, Inc.
Overview
The Enlyte Family of Businesses
Mitchell | Genex | Coventry
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Our suite of products and services enable our employees to help people recover from challenging life events, while providing opportunities for meaningful impact and career growth.
Responsibilities
This is a full-time, on-site opening. and is contracted with the state of Missouri.
Perks : Full and comprehensive benefits program, 24 days of paid vacation / holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, Employee Assistance and Referral Program.
The Tech shall provide the claims adjusting services listed below, related to time lost claims, as directed by the state agency. The Tech shall understand and agree that the determination of a compensable injury will be the responsibility of the state agency. The Tech's services, related to time lost or litigated claims shall include, at a minimum, the following :
Reviewing and investigating claims necessary to process under workers' compensation;
- Reviewing injury reports to determine appropriate medical referrals;
- Assisting injured State of Missouri workers in scheduling and arranging medical examinations;
- Monitoring treatment and processing payment of benefits
- Reviewing medical records and bills for casual relationship, reasonableness, and authorized treatment and then processing for payment within three weeks of receipt of bill and / or documentation
- Contact injured State of Missouri workers within four business days of case assignment, in order to review benefits and obtain additional information
- Calculating benefits with accuracy and maintaining appropriate reserves in accordance with procedures established by the state agency;
- Reviewing medical records, documenting files, and providing copies for the Missouri Assistant Attorney General within two weeks of receipt;
- Ensuring temporary modified duty work slips are documented and provided to the state agency within 24 hours of receipt, to meet the established Early Return to Work program objectives
Position entails working on site with State of Missouri as a contracted employee.
Qualifications
Salary :
Please see job description
PI259515354
